摘要
目的探讨后腹腔镜肾切除术的技术要点和临床效果。方法2004年4月￣2005年10月采用后腹腔镜行单纯肾切除15例,肾癌根治术8例,联合尿道电切镜肾全输尿管切除5例。结石梗阻致肾积水无功能10例,先天性肾盂输尿管连接部狭窄致肾积水无功能3例,萎缩肾2例,肾癌8例,肾盂癌5例。术前均行B超、IVU、CT或MRI检查,健侧肾功能正常,肾脏良性病变提示患肾无功能,肾脏恶性病变选择T1￣T2N0M0病例,肿瘤局限于肾包膜内,肾门及周围淋巴结无肿大。观察手术时间、术中出血量、术中术后并发症及手术效果。结果手术均一次成功,手术时间50￣240min,平均110min,术中出血20￣140mL,术中术后均未输血,引流管拔除时间24￣72h,肠功能恢复时间18￣48h,下床活动时间48￣72h。13例肾脏恶性肿瘤病人已随访3￣18个月,无肿瘤复发及切口种植转移。结论后腹腔镜肾切除术具有创伤小、恢复快、疗效可靠的特点,可部分替代传统的开放手术,具有良好的临床应用前景。
[Objective] To discuss the technical detail of retroperitoneal laparoscopic nephrectomy and evaluate its clinical effect. [Methods] Total 28 cases were performed retroperitoneal laparoscopic nephrectomy from April 2004 to October 2005, including 15 cases of simple nephrectomy, 8 cases of radical nephrectomy, 5 cases of total nephroureterectomy with excision of bladder cuff. Of them, 10 cases had hydronephrosis and non-functioning kidney with calculi, 3 cases had hydronephrosis and non-functioning kidney with ureteropelvic junction obstruction, 2 cases had atrophyorenal, 8 cases had renal carcinoma and 5 cases had renal pelvis carcinoma. B-ultrasound, IVU, CT or MRI were performed before operation in all 28 cases; and renal function were within the normal range, ipsilateral kidney had non-function. Malignant renal neoplasm were all T1-T2N0M0. To evaluate the operative time, blood loss, perioperative complications and operative effect. [Results] All operations were succeeded and effective. The operating time was 50-240 min with an average of 110 min; the blood loss volume was 20-140 mL; the time of disposing of drainage tube was 24-72 h; postoperative intestinal function recovery time was 18-48 h; postoperative ambulation was 48-72 h. All patients did not receive blood transfusion and had no obvious complication. Pollow-up of 3 to 18 months, we have not found any local relapse and tumor seeding of the incision site among 13 renal neoplasm cases. [Conclusions] Retroperitoneal laparoscopic nephrectomy is proved to be effective with minimal invasion,quicker recovery procedure. It can partly take place of conventional open surgery, and will have a good prospect in the urologic clinical practice.
出处
《中国内镜杂志》
CSCD
北大核心
2006年第11期1198-1200,共3页
China Journal of Endoscopy
关键词
腹腔镜
肾切除
经腹膜后
laparoscopy
nephrectomy
retroperitoneal
