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保留肾单位手术中选择性阻断肾段动脉相对肾动脉主干阻断而言是降低术中热缺血损伤的有效术式,研究肾门血管特征并采用合适的肾门探查入路对这一术式至关重要。本研究旨在针对肾段动脉精确阻断下腹腔镜肾部分切除术来建立脉管系统模型以及规范化的肾门探查入路。回顾性研究2009年12月到2011年6月行精确肾段动脉阻断下腹腔镜肾部分切除术的82例患者,平均随访时间为20个月。术前均使用双源CTA行三维肾血管动态重建,基于重建模型确定阻断的靶向肾段的数目、位置、肾门探查入路,在此基础上完成肾肿瘤切除及缝合。用方差检验和确切概率法的单向分析比较不同手术入路的差别。根据双源CTA结果可明确靶向肾段动脉的位置、数目,明确精确的阻断部位,同时可根据肿瘤
Retinal nephron surgery to selectively block the renal artery relative to the main renal artery occlusion is to reduce the intraoperative hot ischemia injury is an effective surgical procedure to study the features of the renal hilar and use of appropriate renal access to this Surgery is crucial. The purpose of this study was to establish a vasculature model and a standardized nephro-exploration approach by precisely sub-laparoscopic partial nephrectomy of the renal arteries. A retrospective study of 82 patients undergoing partial laparoscopic partial nephrectomy from December 2009 to June 2011 with an average follow-up of 20 months was performed. Three-dimensional renal angiographic reconstruction with double-source CTA was performed before surgery. The number and location of targeted renal sections were determined based on the reconstruction model. Renal nephroureterectomy and suture were performed on this basis. One-way analysis of variance test and exact probabilistic method was used to compare the differences between different surgical approaches. According to the results of dual-source CTA can clearly target the location of renal artery, the number of clear and accurate block site, at the same time according to the tumor