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摘要: 传统理念认为肾脏热缺血极限时间小于30 min,否则肾功能出现不可逆性损伤。然此极限值是在肾动静脉同时阻断下诞生的,近来有学者报道腹腔镜下单纯阻断肾动脉时间超过30 min,术后肾功能未发现明显受损。原因是可能肾动静脉同时阻断,与单纯肾动脉阻断,对肾脏热血学损伤的程度不同。可以预期腹腔镜特殊条件下,单纯阻断肾动脉的极限时间可以超过30 min,但尚需动物实验验证。
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[1] 陈宝琦, 于茂生. 缺血性急性肾衰的发病机理研究概况[J]. 国外医学. 泌尿系统分册, 1987, 1(1):13-16.
[2] FANDELLA A, PERNETTI R, MARCHIORI D, et al. The effects of renal ischemia on kidney function in renal cancer conservative surgery[J]. Arch Ital Urol Androl, 2006, 78:117-122.
[3] SIMON J, MEILINGER M, LANG H, et al. Novel technique for in situ cold perfusion in laparoscopic partial nephrectomy[J]. Surg Endosc, 2008, 22:2184-2189.
[4] BERI A, LATTOUF J B, DEAMBROS O, et al. Partial nephrectomy using renal artery perfusion for cold ischemia:functional and oncologic outcomes[J]. J Endourol, 2008, 22:1285-1290.
[5] ANDONIAN S, ADEBAYO A, OKEKE Z, et al. Habib laparoscopic bipolar radiofrequency device:a novel way of creating an avascular resection margin in laparoscopic partial nephrectomy[J]. J Laparoendosc Adv Surg Tech A, 2008, 18:853-856.
[6] OEFELEIN M G. Delayed presentation of urinoma after radiofrequency ablation-assisted laparoscopic partial nephrectomy[J]. J Endourol, 2006, 20:27-30.
[7] CORVIN S, OBERNEDER R, ADAM C, et al. Use of hydro-jet cutting for laparoscopic partial nephrectomy in a porcine model[J]. Urology, 2001, 58:1070-1073.
[8] TERAI A, ITO N, YOSHIMURA K, et al. Laparoscopic partial nephrectomy using microwave tissue coagulator for small renal tumors:usefulness and complications[J]. Eur Urol, 2004, 45:744-748.
[9] SIMONE G, PAPALIA R, GUAGLIANONE S, et al. Preoperative superselective transarterial embolization in laparoscopic partial nephrectomy:technique, oncologic, and functional outcomes[J]. J Endourol, 2009, 23:1473-1478.
[10] HÄCKER A, ALBADOUR A, JAUKER W, et al. Nephron-sparing surgery for renal tumours:acceleration and facilitation of the laparoscopic technique[J]. Eur Urol, 2007, 51:358-365.
[11] FUNAHASHI Y, HATTORI R, YAMAMOTO T, et al. Ischemic renal damage after nephron-sparing surgery in patients with normal contralateral kidney[J]. Eur Urol, 2009, 55:209-215.
[12] PORPIGLIA F, RENARD J, BILLIA M, et al. Is renal warm ischemia over 30 minutes during laparoscopic partial nephrectomy possible? One-year results of a prospective study[J]. Eur Urol, 2007, 52:1170-1178.
[13] TACHIKAKE T, SHIGETA M, MITA K, et al. Decrease of renal function due to warm ischemia after laparoscopic partial nephrectomy:evaluation using 99mTc-DMSA renal scintigraphy[J]. Urol Int, 2009, 82:162-165.
[14] 李建业, 张军晖, 陈宇东, 等. 单纯阻断肾动脉后腹腔镜保留肾单位手术25例临床分析[J]. 中华外科杂志, 2008, 46(24):1885-1886.
[15] GONG E M, ZORN K C, ORVIETO M A, et al. Artery-only occlusion may provide superior renal preservation during laparoscopic partial nephrectomy[J]. Urology, 2008, 72:843-846.
[16] LAVEN B A, ORVIETO M A, CHUANG M S, et al. Renal tolerance to prolonged warm ischemia time in a laparoscopic versus open surgery porcine model[J]. J Urol, 2004, 172:2471-2474.
[17] BENWAY B M, BACA G, BHAYANI S B, et al. Selective versus nonselective arterial clamping during laparoscopic partial nephrectomy:impact upon renal function in the setting of a solitary kidney in a porcine model[J]. J Endourol, 2009, 23:1127-1133.
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