目的探讨腹腔镜下原位低温灌注技术在肾肿瘤部分切除术中的运用,评估可行性及安全性。方法行腹腔镜肾肿瘤部分切术的患者26例,将26例患者随机分为实验组和对照组,每组各13例。实验组采用自制灌注设备,将两根管道从Trocar旁间隙导入体内,穿刺肾动脉进行灌注,将静脉回流液导出体外。对照组按照常规手术方式进行手术。比较两组患者平均手术时间、出血量、灌注时间和术前肌酐。结果 26例患者手术均获成功,实验组体重指数(BMI)为(24.5±3.1)kg/m~2,Radius Exophytic Nearness Anterior Location评分(RENAL)为(3.1±1.1)分,肿瘤直径(3.1±1.1)cm,平均手术时间(15.8±4.1)分钟,出血量(58±8)ml,灌注时间平均5.4秒,术前肌酐(58±11)mmol/L;对照组BMI为(26.0±2.4))kg/m2,RENAL评分(3.3±0.7)分,肿瘤直径(3.2±0.9)cm,平均手术时间(16.5±7.5)分钟,出血量(46±9)ml。两组病例肿瘤大小、手术时间及出血量比较,差异无统计学意义。实验组与对照组术后1周、1个月、3个月肌酐比较,差异有统计学意义(P<0.05),实验组所有病例术后早期肾功能评价优于对照组。所有肿瘤切缘均为阴性。结论采用腹腔镜下原位低温灌注技术,可以将肾脏热缺血变为肾脏冷缺血,为延长手术时间提供保障,同时能够更好的保护肾脏功能。成功手术 Objective To evaluate the feasibility and safety of laparoscopic orthotopic hypothermic perfusion in partial nephrectomy. Methods Totally 26 patients underwent laparoscopic partial nephrectomy, and 26 patients were randomly divided into experimental group and control group, with 13 cases in each group. In the experimental group, self-made perfusion equipment was used to introduce two tubes into the body from the side space of Trocar. The renal artery was punctured for perfusion, and the venous return fluid was exported from the body. The control group underwent conventional surgery. The average operation time, bleeding volume, perfusion time and preoperative creatinine were compared between the two groups. Results Twenty - six patients were successfully operated. The body mass index (BMI) was (3.1 ± 1.1) in the Radius Exophytic Nearness Anterior Location Score (3.1 ± 1.1) and the diameter of the tumor in the experimental group was (24.5 ± 3.1) The mean operative time was 15.8 ± 4.1 minutes, the amount of bleeding was 58 ± 8 ml, the average perfusion time was 5.4 seconds, and the preoperative creatinine was 58 ± 11 mmol / L. The BMI in control group was (26.0 ± 2.4) ), RENAL score (3.3 ± 0.7), tumor diameter (3.2 ± 0.9) cm, average operation time (16.5 ± 7.5) minutes and blood loss (46 ± 9) ml. There was no significant difference in tumor size, operation time and bleeding between the two groups. There were significant differences in creatinine between experimental group and control group at 1 week, 1 month and 3 months postoperatively (P <0.05). Early renal function evaluation of all cases in experimental group was superior to that of control group. All tumor margins were negative. Conclusion The laparoscopic hypothermia perfusion technique can change the renal warm ischemia into renal cold ischemia, which can provide protection for prolonged operation time and better protection of renal function. Successful surgery