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首页> 外文期刊>Urology >Coloepiploic mobilization during left radical nephrectomy for renal cell carcinoma is indicated to reduce the risk of iatrogenic splenectomy.
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Coloepiploic mobilization during left radical nephrectomy for renal cell carcinoma is indicated to reduce the risk of iatrogenic splenectomy.

机译：左肾癌根治术中进行肾上腺动员可降低肾源性脾切除的风险。

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OBJECTIVES: To determine whether coloepiploic mobilization (CEM) is indicated to reduce the incidence of iatrogenic splenectomy during left radical nephrectomy for renal cell carcinoma. The incidence of iatrogenic splenectomy during a left nephrectomy is estimated to be between 1.4% and 24%. In a recent study, we reported that the incidence of iatrogenic splenectomy was 8% during a left nephrectomy performed for renal cell carcinoma through a transperitoneal anterior subcostal incision. METHODS: A left radical nephrectomy was performed in 233 consecutive patients for renal cell carcinoma through a transperitoneal anterior subcostal incision with a CEM procedure in which the left colonic flexure was completely detached from the epiploa. Perioperative and postoperative complications, including splenic injury, were noted in a database. The mean patient age was 51.3 years (range 21.3 to 90.2). The mean tumor size was 58 mm (range 15 to 230). RESULTS: An iatrogenic splenectomy was required in 3 patients, and in 1 patient, a splenic injury was treated conservatively. The incidence of iatrogenic splenectomy accompanying left radical nephrectomy was 1.3%. The mean operative time was 120 minutes (range 80 to 240). The mean time to normal gut motility was 3.4 days (range 2 to 11) and to discharge from the hospital it was 9.3 days (range 6 to 19). Regarding CEM, we did not observe any significant abdominal complications. CONCLUSIONS: The incidence of iatrogenic splenectomy during a left radical nephrectomy through a transperitoneal anterior subcostal incision may be reduced by performing the technique of CEM.
机译：目的：确定是否需要行结肠肾动员（CEM）来减少肾癌左根肾切除术期间医源性脾切除术的发生率。左肾切除术中医源性脾切除术的发生率估计在1.4％至24％之间。在最近的一项研究中，我们报道了通过腹膜前肋下切口对肾细胞癌进行左肾切除术期间，医源性脾切除术的发生率为8％。方法：233例连续的肾细胞癌患者，通过经腹膜前肋膜下切口，采用CEM程序进行左根肾切除术，其中左结肠弯曲部完全脱离了表皮。数据库中记录了包括脾损伤在内的围手术期和术后并发症。患者平均年龄为51.3岁（范围21.3至90.2）。平均肿瘤大小为58毫米（范围从15到230）。结果：3例患者需要进行医源性脾切除术，其中1例患者接受了保守的脾损伤治疗。伴有左根肾切除术的医源性脾切除术的发生率为1.3％。平均手术时间为120分钟（范围为80至240）。正常肠蠕动的平均时间为3.4天（范围2至11），出院时间为9.3天（范围6至19）。关于CEM，我们没有观察到任何明显的腹部并发症。结论：采用CEM技术可降低经腹膜前肋下切口行左根肾切除术期间医源性脾切除的发生率。

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