Application of an “Island hopping” approach in laparoscopic partial nephrectomy for clamping tumor-specific renal arterial branches / 第二军医大学学报

ABSTRACT

Objective To study the feasibiiity and safety of an “island hopping” approach in segmental renal artery dissectlon and clamping m laparoscopic partial nephrectomy. Methods Between August 2014 and August 2015, 10 cadaveric kidneys and 20 kidneys from radicai nephrectomy were used to dissect the renal arteries. The route of renal artery branches and its relationship with location of the renal hilum were observed and recorded A retrospective analysis was made for 10 patients undergoing laparoscopic partial nephrectomy using traditional supersellective artery clamping method (n=5) or “isiand hopping” superselective artery camping method (n=5) The time of dissecting the segmental arteries and the warm ischemia time were recorded and the clinical efficacy of “island hopping” superselective artery clamping method was evaluated. Results For cadaveric kidneys, 72. 2% (39/54) of the renal artery branches entered the kidney along the edge of renal hilum, and the number” was 70. 8% (68/96) in the 20 kidneys from radical nephrectomy clinically the laparoscopic partial nephrectomy procedures were successful in all the 10 patients. One of the 5 cases receiving “island hopping” approach were converted to hilus clamping due to poor operation field for tumor resection. Compared with patients undergoing traditional superseiective artery cliamping, those undergoing “island hopping” approach had a shorter time of dissecting segmental arteries (6-11 min VS 10-18 min) and a similar warm ischemia time (14-26 min vs 15-25 min) Conclusion The “island hopping” approach for tumor-specific renal arterial branches clamping is safe and feasible, and also makes it easier for manipulation, leading to convenient popularization.