ABSTRACT
Objective To compare the feasibility and safety of laparoscopic partial renal segmental artery occlusion and renal artery trunk interruption for partial nephrectomy. Methods We reviewed medical records of 65 patients with stage T1 renal tumor from October 2013 to February 2017. Among them, 29 cases underwent partial nephrectomy with high selective segmental renal artery occlusion, and 36 cases underwent partial nephrectomy with renal artery trunk occlusion. Then compare the preoperative and postoperative creatinine changes, intraoperative blood loss, warm ischemia time, operation time, hospitalization time and positive margins of the two methods. Results In all the patients, the procedures were done without conversion to open surgeries. The operation time of the renal artery branch block group is shorter than that of the main renal artery block, but the preoperative and postoperative creatinine changes are smaller than those of the main renal artery occlusion group. There was no significant difference between the two groups in intraoperative blood loss, warm ischemia time and positive margins (P > 0.05); There was no significant difference between the two groups in age, body mass index (BMI) and R.E.N.A.L score of renal tumor (P > 0.05). Conclusion For the stage T1 renal tumor, the selective renal artery branch interruption technique has a longer operation time, but the renal tissue has a small ischemic zone and has little effect on the kidney.
ABSTRACT
Objective To establish a predictive model of testicular torsion according to the clinical data of pediatric patients with acute scrotum.Methods Retrospective study was performed to analyze medical records of 118 pediatric patients with acute scrotum.A case-control study was conducted,the case group included the patients with testicular torsion and the control group included the patients without testicular torsion.Data of patients including physical signs and laboratory tests related to testicular torsion were assessed by univariate analysis through Chi-square test or t test.All factors which had statistical significance in the univariate analysis were used as independent variables for multivariate Logistic analysis to establish a predictive model of pediatric testicular torsion.Results There were 54 patients in the case group and 64 patients in the control group.Vanishment of cremaster reflex,duration of pain,fever,urine positive and fading away of color Doppler flow imaging (CDFI) were independent predictors of pediatric testicular torsion (all P ＜ 0.05),and the OR values were 4.330,0.888,0.229,0.107 and 4.408,respectively.The predictive model of testicular torsion in pediatric patients was as follows:In [P / (1-P)] =2.307 + 1.466 × vanishment of cremaster reflex-0.119 × duration of pain-1.476 × fever-2.235 × urine positive + 1.484 × CDFI.Conclusions The Logistic regression model,which takes into account vanishment of cremaster reflex,duration of pain,fever,urine positive and CDFI,can be used to predict the risk factors of pediatric testicular torsion to provide a basis of surgical exploration.