CTA指导下腹腔镜肾部分切除术.pptx

Laparoscopic partial nephrenectomy with segmental artery clamping under CTA guidanceYin Changjun Yin Changjun Urology of the first affiliated hospital Urology of the first affiliated hospital of Nanjing Medical Universityof Nanjing Medical UniversityNanjing,ChinaNanjing,ChinaCTAThree dimensional imaging of the renal arteryAnatomy classification of segmental renal artery segmental artery clamping for upper polar tumorsegmental artery clamping for upper polar tumorsegmental artery clamping for upper polar tumorSegmental artery clamping for posterior tumor Segmental artery clamping for posterior tumor Segmental artery clamping for posterior tumor Segmental artery clamping for anterior tumor Segmental artery clamping for anterior tumor Segmental artery clamping for lower polar tumorSegmental artery clamping for lower polar tumorSegmental artery clamping for endophytic tumorSegmental artery clamping for endophytic tumorSegmental artery clamping for endophytic tumorSegmental artery clamping for borderline tumorSegmental artery clamping for borderline tumor Super selective segmental artery clamping under CTA guidance Super selective segmental artery clamping under CTA guidanceMajor Transverse ResectionMajor Transverse ResectionVariable(pre-op)No.of the patients154Tumor location,nPolar36Male,n94Anterior44Age,yrs55.7813.15(1281)Posterior31BMI,kg/m222.81.4(19.125.8)Mixed(ant&post)43Tumor size,cm3.471.39(1.47)Tumor stage,nT1a98Growth pattern,n内生31T1b56外生70Preoperatove GFR level,ml/min(affected side)44.849.58(24.167.2)交界53Clinial data of LPN with segmental artery clamping under CTA guidance in our centreVariable(intra-op/post-op)Operation time,min87.329.85（60120）Major complications,nMajor vessels or organ injury2Clamping time,min23.35.8 （1240）Post-op hemorrhage needs transfusion5EBL,ml230.3140.6（50800）Urine leak0Postoperative GFR level,ml/min29.058.69(9.950.0)Positive surgical margin,n0GFR reduction,%(3m,affected side)35.1215.83 (2.071.0)Follow-up,m 19(329)我科完成的我科完成的CTA指导下腹腔镜肾段动脉阻断指导下腹腔镜肾段动脉阻断肾部分切除术肾部分切除术Thank youThank you！