Technical Improvement Using a Three-Dimensional Video System for Laparoscopic Partial Nephrectomy.
Technical Improvement Using a Three-Dimensional Video System for Laparoscopic Partial Nephrectomy.
复制标题
使用三维视频系统进行腹腔镜肾部分切除术的技术改进。
DOI：
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发表时间：
2016
影响因子：
--
通讯作者：
M. Oya
中科院分区：
文献类型：
--
作者：
Akari Komatsuda;K. Matsumoto;A. Miyajima;G. Kaneko;R. Mizuno;E. Kikuchi;M. Oya
背景
腹腔镜肾部分切除术是治疗肾小肿块的主要手术方法之一。然而，在可接受的时间内管理切割和缝合程序是困难的。为了克服这一困难，我们应用了三维(3D)视频系统配合腹腔镜肾部分切除术，并评估了它的实用性。
材料和方法
我们回顾了2009年11月至2014年6月期间接受腹腔镜肾部分切除术的31名患者。20例患者使用常规二维(2D)视频系统，11例患者使用3D视频系统。记录患者的特征和视频系统类型(2D或3D)，并分析其与围手术期预后的关系。
结果
患者平均年龄55.8±12.4岁，平均体重指数25.7±3.9 kg/m2，平均肿瘤大小2.0±0.8 cm，平均肾功能评分6.9±1.9，临床分期均为T1a。两组在手术时间(p=0.348)、气腹时间(p=0.322)、切开时间(p=0.493)、预计出血量(p=0.335)、Clavien分级并发症发生率(p=0.719)等方面差异无统计学意义。然而，3D组的热缺血时间明显短于2D组(16.1min比21.2分钟，p=0.021)，这是由于缝合时间短(9.1min比15.2min，p=0.008)。两组均未发生开放转换。
结论
3D视频系统可以缩短腹腔镜肾部分切除术中的热缺血时间，因此可能有助于改进手术过程。
BACKGROUND
Laparoscopic partial nephrectomy is one of the major surgical techniques for small renal masses. However, it is difficult to manage cutting and suturing procedures within acceptable time periods. To overcome this difficulty, we applied a three-dimensional (3D) video system with laparoscopic partial nephrectomy, and evaluated its utility.
MATERIALS AND METHODS
We retrospectively enrolled 31 patients who underwent laparoscopic partial nephrectomy between November 2009 and June 2014. A conventional two-dimensional (2D) video system was used in 20 patients, and a 3D video system in 11. Patient characteristics and video system type (2D or 3D) were recorded, and correlations with perioperative outcomes were analyzed.
RESULTS
Mean age of the patients was 55.8±12.4, mean body mass index was 25.7±3.9 kg/m2, mean tumor size was 2.0±0.8 cm, mean R.E.N.A.L nephrometry score was 6.9±1.9, and clinical stage was T1a in all patients. There were no significant differences in operative time (p=0.348), pneumoperitoneum time (p=0.322), cutting time (p=0.493), estimated blood loss (p=0.335), and Clavien grade of >II complication rate (p=0.719) between the two groups. However, warm ischemic time was significantly shorter in the 3D group than the 2D group (16.1 min vs. 21.2min, p=0.021), which resulted from short suturing time (9.1 min vs. 15.2 min, p=0.008). No open conversion occurred in either group.
CONCLUSIONS
A 3D video system allows the shortening of warm ischemic time in laparoscopic partial nephrectomy and thus may be useful in improving the procedure.
影响因子：
6.6
作者：
Miller, DC;Hollingsworth, JM;Hollenbeck, BK
通讯作者：
Hollenbeck, BK
影响因子：
2.1
作者：
Pierorazio PM;Patel HD;Feng T;Yohannan J;Hyams ES;Allaf ME
通讯作者：
Allaf ME