论文部分内容阅读
目的:探讨腹腔镜超声(LUS)在中央型肾肿瘤行腹腔镜肾部分切除术(LPN)的临床价值。方法:回顾分析在LUS协助下行LPN的10例中央型肾肿瘤患者的临床资料。所有患者术前B超、CT和/或MR等影像学检查诊断为肾肿瘤,肿瘤均位于肾实质内,无明显外凸。男6例,女4例,年龄10~62岁(平均45.4岁),5例位于肾中部,1例位于肾上极,4例位于肾下极,肿瘤直径1.1~3.5cm,平均直径2.6cm。结果:腹腔镜术中超声对肿瘤位置、大小、边界和血供进行实时定位,确定肾肿瘤切除的范围,切除后再次复查超声,保证切缘阴性。术后病理回报:肾细胞癌9例,肾素瘤1例,所有切缘均阴性。结论:术中LUS可提供实时影像,协助手术医师准确定位包埋于肾皮质的中央型肾肿瘤,对肿瘤进行实时评估,减少术中出血,保障切缘阴性,为手术安全提供有效保障。
Objective: To investigate the clinical value of laparoscopic ultrasonography (LUS) in the treatment of central renal neoplasms with laparoscopic partial nephrectomy (LPN). Methods: The clinical data of 10 patients with central renal tumors undergoing LUS assisted descending LPN were retrospectively analyzed. All patients with preoperative ultrasound B, CT and / or MR imaging diagnosis of renal tumors, tumors are located in the renal parenchyma, no significant outward convex. 6 males and 4 females, aged 10 to 62 years (mean 45.4 years), 5 in the middle of the kidney, 1 in the upper kidney and 4 in the lower kidney. The tumors were 1.1-3.5 cm in diameter with an average diameter of 2.6 cm . Results: Laparoscopic ultrasound location of tumor, size, border and blood supply for real-time positioning to determine the scope of resection of renal tumor resection ultrasound review again to ensure negative margins. Postoperative pathological findings: renal cell carcinoma in 9 cases, 1 case of renin, all the margins were negative. CONCLUSIONS: Intraoperative LUS provides real-time images to assist surgeons in accurately locating the central renal tumor embedded in the renal cortex. Real-time evaluation of the tumor, reducing intraoperative bleeding and ensuring negative margins provide an effective guarantee for surgical safety.