The clinical application of the sliding loop technique for renorrhaphy during robot-assisted laparoscopic partial nephrectomy: Surgical technique and outcomes

H. S. Kim, Young Ju Lee, J. Ku, C. Kwak, Hyeon-Hoe Kim, C. Jeong
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引用次数: 4

Abstract

Purpose To report the initial clinical outcomes of the newly devised sliding loop technique (SLT) used for renorrhaphy in patients who underwent robot-assisted laparoscopic partial nephrectomy (RALPN) for small renal mass. Materials and Methods We reviewed the surgical videos and medical charts of 31 patients who had undergone RALPN with the SLT renorrhaphy performed by two surgeons (CWJ and CK) between January 2014 and October 2014. SLT renorrhaphy was performed after tumor excision and renal parenchymal defect repair. Assessed outcomes included renorrhaphy time (RT), warm ischemic time, perioperative complications, and perioperative renal function change. RT was defined as interval from the end of bed suture to the renal artery declamping. Results In all patients, sliding loop renorrhaphy was successfully conducted without conversions to radical nephrectomy or open approaches. Mean renorrhaphy and warm ischemic time were 9.0 and 22.6 minutes, respectively. After completing renorrhaphy, there were no adverse events such as dehiscence of approximated renal parenchyma, renal parenchymal tearing, or significant bleeding. Furthermore, no postoperative complications or significant renal function decline were observed as of the last follow-up for all patients. The limitations of this study include the small volume case series, the retrospective nature of the study, and the heterogeneity of surgeons. Conclusions From our initial clinical experience, SLT may be an efficient and safe renorrhaphy method in real clinical practice. Further large scale, prospective, long-term follow-up, and direct comparative studies with other techniques are required to confirm the clinical applicability of SLT.
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滑环技术在机器人辅助腹腔镜肾部分切除术中的临床应用:手术技术和结果
目的报告新设计的滑动环技术(SLT)用于机器人辅助腹腔镜部分肾切除术(RALPN)小肾肿块患者肾修补的初步临床结果。材料与方法回顾2014年1月至2014年10月间由CWJ和CK两位外科医生行SLT再缝合术的31例RALPN患者的手术录像和病历。肿瘤切除及肾实质缺损修复后行SLT再吻合。评估结果包括修复时间(RT)、热缺血时间、围手术期并发症和围手术期肾功能变化。RT定义为从床端缝合到肾动脉去支的时间间隔。结果所有患者均成功行滑动环肾吻合术,未转行根治性肾切除术或开放入路。平均再缝合时间为9.0分钟,热缺血时间为22.6分钟。完成肾修补后,没有出现邻近肾实质裂开、肾实质撕裂或明显出血等不良事件。此外,截至最后一次随访,所有患者均未出现术后并发症或明显的肾功能下降。本研究的局限性包括病例量小、研究的回顾性以及外科医生的异质性。结论从我们初步的临床经验来看,SLT在实际临床中可能是一种有效、安全的再缝合方法。需要进一步的大规模、前瞻性、长期随访以及与其他技术的直接比较研究来证实SLT的临床适用性。
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