殷長(zhǎng)軍CTA指導(dǎo)下腹腔鏡腎部分切除術(shù)課件

1、Laparoscopic partial nephrenectomy with segmental artery clamping under CTA guidanceYin Changjun Urology of the first affiliated hospital of Nanjing Medical UniversityNanjing, China殷長(zhǎng)軍CTA指導(dǎo)下腹腔鏡腎部分切除術(shù)1Laparoscopic partial nephrenecCTAThree dimensional imaging of the renal artery殷長(zhǎng)軍CTA指導(dǎo)下腹腔鏡腎部分切除術(shù)2CTA

2、Three dimensional imagingAnatomy classification of segmental renal artery 殷長(zhǎng)軍CTA指導(dǎo)下腹腔鏡腎部分切除術(shù)3Anatomy classification of segsegmental artery clamping for upper polar tumor殷長(zhǎng)軍CTA指導(dǎo)下腹腔鏡腎部分切除術(shù)4segmental artery clamping for segmental artery clamping for upper polar tumor殷長(zhǎng)軍CTA指導(dǎo)下腹腔鏡腎部分切除術(shù)5segmental artery

3、 clamping for segmental artery clamping for upper polar tumor殷長(zhǎng)軍CTA指導(dǎo)下腹腔鏡腎部分切除術(shù)6segmental artery clamping for Segmental artery clamping for posterior tumor 殷長(zhǎng)軍CTA指導(dǎo)下腹腔鏡腎部分切除術(shù)7Segmental artery clamping殷長(zhǎng)軍CTSegmental artery clamping for posterior tumor 殷長(zhǎng)軍CTA指導(dǎo)下腹腔鏡腎部分切除術(shù)8Segmental artery clamping殷長(zhǎng)軍CT

4、Segmental artery clamping for posterior tumor 殷長(zhǎng)軍CTA指導(dǎo)下腹腔鏡腎部分切除術(shù)9Segmental artery clamping殷長(zhǎng)軍CTSegmental artery clamping for anterior tumor 殷長(zhǎng)軍CTA指導(dǎo)下腹腔鏡腎部分切除術(shù)10Segmental artery clamping殷長(zhǎng)軍CTSegmental artery clamping for anterior tumor 殷長(zhǎng)軍CTA指導(dǎo)下腹腔鏡腎部分切除術(shù)11Segmental artery clamping for Segmental arter

5、y clamping for lower polar tumor殷長(zhǎng)軍CTA指導(dǎo)下腹腔鏡腎部分切除術(shù)12Segmental artery clamping for殷Segmental artery clamping for lower polar tumor殷長(zhǎng)軍CTA指導(dǎo)下腹腔鏡腎部分切除術(shù)13Segmental artery clamping for殷Segmental artery clamping for endophytic tumor殷長(zhǎng)軍CTA指導(dǎo)下腹腔鏡腎部分切除術(shù)14Segmental artery clamping for殷Segmental artery clamping

6、 for endophytic tumor殷長(zhǎng)軍CTA指導(dǎo)下腹腔鏡腎部分切除術(shù)15Segmental artery clamping for殷Segmental artery clamping for endophytic tumor殷長(zhǎng)軍CTA指導(dǎo)下腹腔鏡腎部分切除術(shù)16Segmental artery clamping for Segmental artery clamping for borderline tumor殷長(zhǎng)軍CTA指導(dǎo)下腹腔鏡腎部分切除術(shù)17Segmental artery clamping for殷Segmental artery clamping for borderl

7、ine tumor殷長(zhǎng)軍CTA指導(dǎo)下腹腔鏡腎部分切除術(shù)18Segmental artery clamping for殷 Super selective segmental artery clamping under CTA guidance殷長(zhǎng)軍CTA指導(dǎo)下腹腔鏡腎部分切除術(shù)19 Super selective segmental art Super selective segmental artery clamping under CTA guidance殷長(zhǎng)軍CTA指導(dǎo)下腹腔鏡腎部分切除術(shù)20 Super selective segmental artMajor Transverse Re

8、section殷長(zhǎng)軍CTA指導(dǎo)下腹腔鏡腎部分切除術(shù)21Major Transverse Resection殷長(zhǎng)軍CMajor Transverse Resection殷長(zhǎng)軍CTA指導(dǎo)下腹腔鏡腎部分切除術(shù)22Major Transverse Resection殷長(zhǎng)軍CVariable (pre-op)No. of the patients154Tumor location, nPolar36Male, n94Anterior44Age, yrs55.7813.15(1281)Posterior31BMI, kg/m222.81.4 (19.125.8)Mixed (ant&post)43Tumo

9、r size, cm3.471.39 (1.47)Tumor stage, nT1a98Growth pattern, n內(nèi)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 centre殷長(zhǎng)軍CTA指導(dǎo)下腹腔鏡腎部分切除術(shù)23Variable (pre-op)No. of the paVariable(intra-op/post-

10、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)