摘要
目的:探讨经脐单孔腹腔镜技术在肾部分切除术中应用的可行性及安全性。方法:回顾性分析15例经脐单孔腹腔镜技术行肾部分切除术的临床资料。其中左侧肾肿瘤6例,右侧9例;肿瘤位于肾脏上极7例、中部3例、下极5例;其中外生型肿瘤11例、中间型3例、内生型1例;肿瘤位于腹侧者10例、背侧者5例。肿瘤最长径1.8~5.0cm,平均3.6cm。分别记录手术时间、热缺血时间、术中出血量、术中是否增加辅助Trocar、术后住院天数、术后引流管拔除时间、术后镇痛药使用情况、术中和术后并发症及病理切缘情况等。结果:15例手术均获成功。手术时间78~153min,平均105.3min;热缺血时间17~35min,平均22.8min;术中出血量55~220ml,平均95.5ml。无中转常规腹腔镜及开放手术,2例增加一5mm辅助Trocar。术后住院时间7~10d,平均8.8d;术后拔除引流管时间2~5d,平均3.5d。术后无出血、漏尿等并发症发生;2例术后24小时内应用镇痛药。病理学检查提示:手术切缘均为阴性。结论:经脐单孔腹腔镜技术在肾部分切除术中应用安全有效,且术后患者恢复快,美容效果佳,可在临床选用。
Objective：To evaluate the feasibility and safety of transumbilical laparoendoscopic single-site surgery（LESS）in partial nephrectomy.Method：The clinical data of 15 patients who underwent partial nephrectomy by transumbilical LESS were analyzed.There were six cases on the left side and nine cases on the right side.The operative time,warm ischemia time,estimated blood loss,postoperative hospitalization time,time for drainage,analgesic drug usage after operation,whether to use an ancillary Trocar,postoperative complications and pathological margin were recorded respectively.Result：All of the operations were successful.The mean operation time was 105.3（range,78-153）min,and the mean warm ischemia time was 22.8（range,17-35）min.The mean estimated blood loss was 95.5（range,55-220）ml.There was no blood transfusion.There was no patient who required conversion to standard laparoscopy or open surgery.Two cases needed a 5-mm ancillary Trocar.The mean hospitalization time was 8.8（range,7-10）d.The mean time for drainage was 3.5（range,2-5）d.Two cases needed analgesics within 24 hours postoperatively.There was no postoperative bleeding,leakage or other complications.Pathological examination showed that the margins were negative.Conclusion：Transumbilical LESS in partial nephrectomy is safe and effective,with rapid postoperative recovery and good cosmetic results.It is worth applying in clinical practice.
作者
邓仲磊
袁琳
苏健
朱辰
张扬
魏云飞
卢子杰
苏昀
顾晓箭
朱清毅
DENG Zhonglei YUAN Lin SU Jian ZHU Chen ZHANG Yang WEI Yunfei LUZijie SUYun GUXiaojian ZHUQingyi(Department of Urology, Jiangsu Provincial Hospital of Traditional Chinese Medicine, Nanjing University of Traditional Chinese Medicine, Nanjing, 210029, China)
出处
《临床泌尿外科杂志》
2017年第3期181-183,188,共4页
Journal of Clinical Urology
关键词
经脐途径
单孔腹腔镜
肾部分切除术
transumbilical approach
laparoendoscopic single-site surgery
partial nephrectomy
