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首页> 外文期刊>BJU international >Nephron-sparing surgery: a call for greater application of established techniques.
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Nephron-sparing surgery: a call for greater application of established techniques.

机译：保留肾单位的肾脏手术：呼吁更多地使用既有技术。

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OBJECTIVES: To examine the results of open partial nephrectomy (OPN) over a 15-year period in a large UK teaching hospital and to compare results with other series including minimally invasive techniques, as nephron-sparing techniques are still under-utilized in the surgical treatment of renal carcinoma. A standardized technique is described that we think minimizes the risk of postoperative urinoma. PATIENTS AND METHODS: We retrospectively reviewed a series of 141 patients who underwent OPN performed over a 15-year period in one centre by the senior author (D.M.A.W.). A notable feature of this series compared with others is the high proportion of patients undergoing other major synchronous surgery. RESULTS: In all, 141 patients underwent 147 OPNs, with six undergoing bilateral procedures, of which 82 were for imperative indications (single kidney, bilateral synchronous tumours, or pre-existing renal impairment). There were three perioperative deaths, two in patients undergoing other synchronous major surgery. In all, 38 patients had postoperative complications: 28 patients required blood transfusion (four required intervention for their bleeding), five required acute dialysis and three late dialysis. There was a 90% cancer-specific survival rate at a median follow-up of 2 years. CONCLUSIONS: This series confirms the trend towards improved outcomes and decreased complications in OPN at a time when its place is challenged by minimally invasive techniques.
机译：目的：在一家大型英国教学医院中检查开放性部分肾切除术（OPN）在15年期间的结果，并将其与包括微创技术在内的其他系列结果进行比较，因为在手术中仍未充分利用保留肾单位的技术肾癌的治疗。描述了一种标准化技术，我们认为该技术可最大程度地减少术后尿路上皮瘤的风险。病人和方法：我们回顾性分析了由资深作者（D.M.A.W.）在一个中心进行的15年间OPN手术的141例患者。与其他系列相比，该系列的显着特点是接受其他大型同步手术的患者比例很高。结果：总共141例患者接受了147例OPN，其中6例接受了双侧手术，其中82例用于紧急指征（单肾，双侧同步性肿瘤或既往存在肾功能不全）。围手术期死亡3例，其他同步大手术患者2例。共有38例患者发生了术后并发症：28例需要输血（四例需要介入治疗以防出血），五例需要进行急性透析和三例进行后期透析。在2年的中位随访中，癌症特异性生存率为90％。结论：该系列证实了在微创技术挑战其位置的同时，OPN具有改善结果并减少并发症的趋势。

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