摘要
目的 介绍单孔单通道后腹腔镜下肾囊肿去顶术的手术方法及经验. 方法 2009年4月至2011年5月采用单孔单通道后腹腔镜下肾囊肿去顶术治疗肾囊肿患者42例,男24例,女18例.年龄32～78岁,平均45岁.左侧21例,右侧18例,双侧3例.囊肿大小4.4～ 12.6 cm,平均6.5 cm.术中采用10 mm套管穿至后腹腔间隙,置入侧视式腹腔镜（带有一个操作通道）操作.沿囊肿边缘分离、切开囊壁,并利用囊腔作为操作间隙,将腹腔镜置入囊腔内操作,切断囊肿边缘一周,再将囊肿顶部自肾周脂肪组织上剥脱. 结果 40例手术顺利完成；2例因囊肿腔张开较差,加用1个5 mm套管协助完成手术.均为单人完成手术.手术时间20 ～ 65 min,平均36 min；术中出血量0～115 ml,平均18 ml.29例术后当天下床活动,13例术后第1天下床活动.术后1～4d拔除引流管；住院时间1～5d,平均2.6d.37例术后随访3～19个月,平均8.2个月.B超或CT复查无复发,未发生其他并发症. 结论 单孔单通道后腹腔镜下肾囊肿去顶术与标准后腹腔镜术式比较,美容效果较好,囊肿分离创伤小,手术安全性高,效果好,并可节省人力成本.
Objective To discuss a method of single-port retroperitoneal laparoscopy for the treat- ment of renal cysts. Methods From April 2009 to May 2011, 42 patients （24 males and 18 females with mean age of 45 yrs） were performed single-port retroperitoneoscopic decortication of renal cysts. The renal cysts size ranged from 4.4 cm to 12.6 cm, mean size 6.5 era. The cysts were on the left side in 21 cases, on the right in 18 cases, on both sides in three cases. In the operative procedure, only one 10mm Trocar were used to pass a laparoscope that had a work channel. By dissected along the margin of the cyst and incised, the roof of the cyst was divided. Then the roof of cyst was peeled away from the perirenal adipose tissue. Results The procedure was completed successfully in all of the cases except two cases of which the cavity of the cyst was not open up well, and one additional 5 mm Trocar was used to assist completing the task. All the procedures were accomplished with no assistant. The operating time was 20-65 min （mean 36 min） and intr- aoperative blood loss was 0-115 ml （mean 18 ml）. Postoperative hospital stay were 1-5 d （mean 2.6 d）. 37 patients were available during the follow-up of 3-19 months （mean 8.2 months）, no compl!cation was found. Conclusions Compared to the conventional ones in the decoration of renal cyst, the method of sin- gle-port retroperitoneoscopy has the cosmetic benefit, it could reduce the trauma of dissection and the com- plication.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2013年第9期662-665,共4页
Chinese Journal of Urology
关键词
肾囊肿
腹膜后腔
单孔法
Renal cyst
Retroperitoneal space
Single-port
