Clinical value of renal vascular CT angiography in retroperitoneal laparoscopic partial nephrectomy

Abstract:

Objective：To evaluate the clinical application value of renal vascular computed tomography angiography（CTA） during retroperitoneal laparoscopic partial nephrectomy. Methods：Totally 40 patients needing for retroperitoneal laparoscopic partial nephrec－tomy were divided into two groups randomly. The variations of renal artery were investigated via CTA and the perioperative surgical outcomes were analyzed between the two groups，including operative time，warm ischemia time，blood loss，postoperative hospital stay，GFR reduction，and the incidence of complications. Results：Renal artery distribution of CTA was consistent with the intraoperative anatomical situation. One case in CTA group was diverted into laparoscopic radical nephrectomy，two cases in control group were con－verted to open radical nephrectomy and seven cases in CTA group accepted the selective blocking of renal artery surgery. No signif－icant complication and positive margin was found. The warm ischemia time of CTA group and control group was （27.4 ± 6.2） min and （29.2±5.1） min（t=1.00，P=0.322），without statistical differences（t=1.00，P=0.322）. Blood loss（33.3 ± 11.0） ml，postoperative hospital stay（4.2 ± 0.8） d and GFR reduction （6.1±2.1） ml/min of CTA group were significantly lower than those of control group（t=4.04，P=0.001；t=2.85，P=0.007；t=3.06，P=0.004）. Conclusion：CTA can provide effective guidance for retroperitoneal laparoscopic partial nephrectomy and should become a routine preoperative examination.