殷长军CTA指导下腹腔镜肾部分切除术课件

1、Laparoscopic partial nephrenectomy with segmental artery clamping under CTA guidanceYin Changjun Urology of the first affiliated hospital of Nanjing Medical UniversityNanjing, China殷长军CTA指导下腹腔镜肾部分切除术1Laparoscopic partial nephrenecCTAThree dimensional imaging of the renal artery殷长军CTA指导下腹腔镜肾部分切除术2CTA

2、Three dimensional imagingAnatomy classification of segmental renal artery 殷长军CTA指导下腹腔镜肾部分切除术3Anatomy classification of segsegmental artery clamping for upper polar tumor殷长军CTA指导下腹腔镜肾部分切除术4segmental artery clamping for segmental artery clamping for upper polar tumor殷长军CTA指导下腹腔镜肾部分切除术5segmental artery

3、 clamping for segmental artery clamping for upper polar tumor殷长军CTA指导下腹腔镜肾部分切除术6segmental artery clamping for Segmental artery clamping for posterior tumor 殷长军CTA指导下腹腔镜肾部分切除术7Segmental artery clamping殷长军CTSegmental artery clamping for posterior tumor 殷长军CTA指导下腹腔镜肾部分切除术8Segmental artery clamping殷长军CT

4、Segmental artery clamping for posterior tumor 殷长军CTA指导下腹腔镜肾部分切除术9Segmental artery clamping殷长军CTSegmental artery clamping for anterior tumor 殷长军CTA指导下腹腔镜肾部分切除术10Segmental artery clamping殷长军CTSegmental artery clamping for anterior tumor 殷长军CTA指导下腹腔镜肾部分切除术11Segmental artery clamping for Segmental arter

5、y clamping for lower polar tumor殷长军CTA指导下腹腔镜肾部分切除术12Segmental artery clamping for殷Segmental artery clamping for lower polar tumor殷长军CTA指导下腹腔镜肾部分切除术13Segmental artery clamping for殷Segmental artery clamping for endophytic tumor殷长军CTA指导下腹腔镜肾部分切除术14Segmental artery clamping for殷Segmental artery clamping

6、 for endophytic tumor殷长军CTA指导下腹腔镜肾部分切除术15Segmental artery clamping for殷Segmental artery clamping for endophytic tumor殷长军CTA指导下腹腔镜肾部分切除术16Segmental artery clamping for Segmental artery clamping for borderline tumor殷长军CTA指导下腹腔镜肾部分切除术17Segmental artery clamping for殷Segmental artery clamping for borderl

7、ine tumor殷长军CTA指导下腹腔镜肾部分切除术18Segmental artery clamping for殷 Super selective segmental artery clamping under CTA guidance殷长军CTA指导下腹腔镜肾部分切除术19 Super selective segmental art Super selective segmental artery clamping under CTA guidance殷长军CTA指导下腹腔镜肾部分切除术20 Super selective segmental artMajor Transverse Re

8、section殷长军CTA指导下腹腔镜肾部分切除术21Major Transverse Resection殷长军CMajor Transverse Resection殷长军CTA指导下腹腔镜肾部分切除术22Major Transverse Resection殷长军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 centre殷长军CTA指导下腹腔镜肾部分切除术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)