Laparoscopic nephron-sparing surgery: preoperative assessment with three-dimensional computed tomography.
Laparoscopic nephron-sparing surgery: preoperative assessment with three-dimensional computed tomography.
复制标题
腹腔镜保留肾单位手术：三维计算机断层扫描术前评估。
DOI：
10.1016/j.eururo.2004.08.008
复制
发表时间：
2005
期刊：
影响因子：
23.4
通讯作者：
Katsuhide Ito
中科院分区：
文献类型：
--
作者：
Kazushi Marukawa;J. Horiguchi;M. Shigeta;Y. Akiyama;K. Mita;T. Usui;K. Arihiro;Katsuhide Ito
目的了解后腹膜腔微波组织凝固器在保留肾单位的手术中肿瘤、收集系统和血管之间的关系，有助于预防尿漏和血管损伤。方法对15例直径小于3 cm的肾小肿瘤，在注射造影剂30ml后10分钟行动态CT扫描。建立多平面重建、容积再现和最大密度投影图像，用于确定手术入路和计划手术。结果所有病例均在多平面重建上测量肿瘤与收集系统的距离。因此，5例患者被指定为使用微波组织凝固器进行后腹膜腔镜肾单位保留手术。其余10例，由于距离短(小于10 mm)，不被认为是该手术的良好候选者。多平面重建和3D-CT能很好地显示肿瘤、收集系统和血管之间的关系。结论多平面重建和3D-CT能帮助我们了解周围结构。它们有助于明确使用微波组织凝固器的后腹膜后腹腔镜肾单位保留手术的适应症，以及术前计划保留肾单位的手术。
OBJECTIVEFor retroperitoneal laparoscopic nephron-sparing surgery using a microwave tissue coagulator, it is helpful to know the relationship between the tumour, collecting system and vessels to prevent urinary leakage and vascular damage. We assessed the efficacy of multiplanar reformation and three-dimensional (3D) CT with the renal collecting system filled with contrast medium.METHODSFifteen patients with small renal tumours of less than 3cm in diameter underwent dynamic CT examination ten minutes after injection of contrast medium of 30ml. Multiplanar reformation, volume-rendered and maximum intensity projection images were created for determining operative approaches and for planning the operation.RESULTSIn all cases, the distance between the tumour and collecting system was measured on the multiplanar reformation. Accordingly, five cases were indicated for retroperitoneal laparoscopic nephron-sparing surgery using a microwave tissue coagulator. The remaining ten cases, due to the short distance (less than 10mm), were not considered good candidates for this procedure. The relationship between the tumour, collecting system and vessels was well shown on the volume-rendered and maximum intensity projection images.CONCLUSIONSMultiplanar reformation and 3D-CT are able to give us an understanding of the surrounding structures. They are helpful in defining the indications for retroperitoneal laparoscopic nephron-sparing surgery using a microwave tissue coagulator and preoperative planning of nephron-sparing surgery.