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评价腹腔镜下零缺血免缝合钬激光肾部分切除术的临床应用价值,探讨该项技术在缩短术中肾脏缺血时间、减少肾脏组织损伤范围等方面的有效性及安全性。“零缺血”技术即术中不阻断肾动脉,“免缝合”技术即不用传统的缝线方式缝合肾脏创面止血,而是通过钬激光烧灼创面达到止血目的。根据笔者所在医院初期开展的腹腔镜下零缺血免缝合钬激光肾部分切除术及参考国内外相关文献报道情况,“零缺血”技术可最大程度减少肾脏热缺血时间,避免肾功损害,“免缝合”技术可有效减少肾脏组织损伤范围,“钬激光”应用于肾部分切除术,一方面可进行术中止血,避免对肾脏创面的缝合,另一方面相比传统的缝线缝合方式,钬激光对肾脏组织的损伤范围更小。将“零缺血”、“免缝合”、“钬激光”三种技术同时用于腹腔镜肾部分切除术,可最大程度避免术中肾功损害、减少肾脏组织的损伤范围。在掌握适应证的前提下,该项技术安全可靠,可以明显减少手术时间,缩短术中肾脏热缺血时间,减少肾脏组织的损伤范围。
To evaluate the clinical value of laparoscopic zero-dose holmium laser in the treatment of partial nephrectomy and to explore the effectiveness and safety of this technique in shortening the duration of renal ischemia and reducing the extent of renal damage. “Zero ischemia ” technology that does not block the renal artery surgery, “Free suture ” technology that is not the traditional way of suture the kidney wound to stop bleeding, but through the holmium laser burn wound to achieve the purpose of bleeding. According to the author’s hospital at the beginning of laparoscopic zero-ISH-free suture holmium laser partial nephrectomy and reference to relevant literature reports at home and abroad, “zero ischemia ” technology can minimize renal warm ischemia time and avoid the kidney Power damage, “Free suture ” technology can effectively reduce the scope of renal tissue damage, “holmium laser ” applied to partial nephrectomy, on the one hand can be intraoperative hemostasis, to avoid suture of the kidney wound, on the other hand Than the traditional way of suture, holmium laser damage to the kidneys in a smaller area. The three techniques of “zero ischemia”, “free suture”, “holmium laser” are also used in laparoscopic partial nephrectomy to avoid intraoperative renal damage and reduce renal tissue damage range. In the premise of indications, the technology is safe and reliable, can significantly reduce the operation time and shorten the renal warm ischemia during the operation, reduce the scope of renal tissue damage.