The safety and efficacy of retroperitoneoscopic microwave ablation (MWA) in the treatment of renal hamartoma were evaluated.From July 2007 to July 2009, a total of 16 cases of renal hamartoma were treated with retrope...The safety and efficacy of retroperitoneoscopic microwave ablation (MWA) in the treatment of renal hamartoma were evaluated.From July 2007 to July 2009, a total of 16 cases of renal hamartoma were treated with retroperitoneoscopic MWA.Peri-and post-operative findings were observed.Middle-term efficacy was assessed by contrast-enhanced computerized tomography (CT) in follow-up period.All patients received MWA of 1-5 points.The mean operative time was 85 min and the mean blood loss was 65 mL.During a median follow-up of 16 months, no evidence of disease recurrence was observed despite of incomplete ablation in 1 case.Retroperitoneoscopic MWA is a relatively simple procedure with less impact to renal function and less complication.The outcome of middle-term follow-up is satisfactory.Thus, retroperitoneoscopic MWA appears to be a safe and effective technique for renal hamartoma in selected patients.展开更多
The occurrence of adrenal crisis after retroperitoneal laparoscopic unilateral adrenalectomy is usually concealed.If not timely diagnosis and treatment,it may cause shock,and even lead to death.It is very difficult to...The occurrence of adrenal crisis after retroperitoneal laparoscopic unilateral adrenalectomy is usually concealed.If not timely diagnosis and treatment,it may cause shock,and even lead to death.It is very difficult to distinguish the clinical manifestations of adrenal crisis from nausea,vomiting,fatigue,gas separation from the lower diaphragm,abdominal pain,hypotension,hypertension,fever and hypothermia after operation.This makes it very difficult to identify and diagnose adrenal crisis early.This article mainly discusses the early recognition,diagnosis and treatment of adrenal crisis after unilateral adrenalectomy by retroperitoneoscope.展开更多
Objective: To study the Laparoscopic kidney cancer after Radical prostatectomy, Laparoscopic Radical Nephrectomy, LRN) stress index, tumor markers, and renal function in patients with kidney cancer. Methods: A total o...Objective: To study the Laparoscopic kidney cancer after Radical prostatectomy, Laparoscopic Radical Nephrectomy, LRN) stress index, tumor markers, and renal function in patients with kidney cancer. Methods: A total of 80 patients with renal cancer treated in our hospital were randomly divided into control group and study group (40 patients in each group). The changes of stress index, tumor marker and renal function before and after operation were compared between the two groups. Results: After operation, stress index, tumor marker and other indicators in both groups were significantly reduced, while the levels of FT3 and FT4 in patients undergoing retroperitoneal laparoscopic radical nephrectomy were significantly lower than those in the control group. After laparoscopic radical resection, tumor inflammatory factors such as CA50, CEA and CA125, as well as inflammatory factors such as TNF-α, serum cortisol and c-reactive protein (CRP) were significantly reduced compared with the control group. Meanwhile, the decreased levels of blood urea nitrogen (BUN) and blood creatinine (SCr) in the study group were significantly higher than those in the control group, indicating that the recovery of renal function in the study group was better than that in the control group. Conclusions: Compared with open radical nephrectomy, retroperitoneal laparoscopic radical nephrectomy can effectively reduce the stress response, inflammatory factors, inflammatory reaction and tumor markers, and significantly improve the recovery of renal function.展开更多
Minimally invasive adrenalectomy has become the main treatment modality for most adrenal lesions.Both laparoscopic transabdominal and retroperitoneoscopic approaches are safe and feasible options,each with respective ...Minimally invasive adrenalectomy has become the main treatment modality for most adrenal lesions.Both laparoscopic transabdominal and retroperitoneoscopic approaches are safe and feasible options,each with respective advantages,including better surgical outcomes,fewer complications,and faster recovery over open adrenalectomy.While open surgery remains a valid modality in treatment of adrenocortical cancer in the presence of some findings such as invasion,robotic platforms,and minimally invasive surgery have gained popularity as technology continues to evolve.Organ preservation during adrenalectomy is feasible in some conditions to prevent adrenal insufficiency.Ablative technologies are increasingly utilized in benign and malignant tumors,including the adrenal gland,with various outcomes.A multidisciplinary team,an experienced surgeon,and a highvolume center are recommended for any surgical approaches and management of adrenal lesions.This review article evaluated recent findings and current evidence on minimally invasive adrenalectomy.展开更多
Background: Retroperitoneal laparoscopic nephropexy has been applied to nephroptosis. We investigate the approach and treatment effect of retroperitoneal laparoscopic nephropexy. Methods:?From May 1990 to October 2013...Background: Retroperitoneal laparoscopic nephropexy has been applied to nephroptosis. We investigate the approach and treatment effect of retroperitoneal laparoscopic nephropexy. Methods:?From May 1990 to October 2013, 45 patients with nephroptosis treated in our hospital were retrospectively analyzed. Among them, 25 patients underwent nephropexy (open surgery group), the other 20 patients underwent?retroperitoneal laparoscopic nephropexy (laparoscopic surgery group). In open surgery group,?there were 24 females and 1 male, aged 20 - 35 years. In laparoscopic surgery group, there were 19 females and 1 male, aged 20 - 35 years.?All of them with?nephroptosis of the right kidney were combined with lower back pain or hematuria and underwent intravenous pyelography (IVP) and color?ultrasound?in?orthostatic and supine position for a specific diagnosis. In open surgery group, patients underwent open surgery. Their kidneys were?fully dissociated,?then, the upper and?middle pole of the dorsal kidney was?sutured?with?lumbar fascia?for two stitches for fixation respectively. While in?laparoscopic surgery group,?kidneys were fully dissociated in Gerota’s fascia during laparoscopic surgery, and?the upper pole of the dorsal kidney was sutured?with the?lumbar fascia for?two?stitches using a?2-0 absorbable suture. They were all in the supine position for a week after surgery.?The?body mass index (BMI), operation time, bleeding?amount,?postoperative hospital stay,?wound complication rate and other indicators were compared between two groups. Results:?BMI in open surgery group was 16.77 ± 0.80 kg/m2, BMI in?laparoscopic surgery group was 16.73 ± 0.78 kg/m2, P > 0.05 showed no statistical difference;the operation time in open surgery group was 70.96 ± 10.61 min, that in laparoscopic surgery group was 34.65 ± 4.87 min, P?< 0.001?showed highly statistical significance;the bleeding amount in open surgery group was 20.65 ± 6.48 ml, that in laparoscopic surgery group was 4.85 ± 1.63ml, P < 0.001 showed highly statistical significance;the postoperative hospital stay in open surgery group was 7.54 ± 1.28 d, that in laparoscopic surgery group was 7 d, P > 0.05 showed no statistical difference. In open surgery group, four patients had?wound infection which delayed the healing, and the wound complication rate was 16% (4/25). In laparoscopic surgery group,?wound complications did not appear, the incidence was 0%, X2 = 1.8144, P > 0.05 showed no statistical difference. The mean follow-up visit lasted 1.5 years after surgery (3 months to 2 years), B-mode ultrasound in orthostatic and supine position showed kidneys were in the normal position. Compared with those before surgery, postoperative uncomfortable symptoms completely disappeared in all patients. Conclusions: Retroperitoneal laparoscopic nephropexy has a good effect on?symptomatic?nephroptosis. The two stitches?of suture between the upper pole of the dorsal kidney and the lumbar fascia show?convenient operation, less damage and?faster postoperative recovery, which are better than open surgery.展开更多
Objective To discover the anatomical basis of retroperitoneoscopic surgery. Methods Twenty Chinese adult cadavers including 12 men and 8 women were anatomized. The relationship between nerves, vessels of the lateral a...Objective To discover the anatomical basis of retroperitoneoscopic surgery. Methods Twenty Chinese adult cadavers including 12 men and 8 women were anatomized. The relationship between nerves, vessels of the lateral abdominal wall, retroperitoneal structures and the path of retroperitoneoscopic surgery were measured. Results In male cadavers, the distance between the iliac crest and trigonum lumbale was 4.02±1.26 cm on the left, and 3.83 ± 0.90 cm on the right. The distance between the iliac crest and iliohypogastricus nerve was 0.82 ± 0.13 cm on the left and 0.84±0.08 cm on the right. The distance between the subcostal nerve and Ⅻ rib in the posterior axillary line and midaxillary line was 0.79 ±0.26 cm,1.65± 1.12 cm on the left and 0.78 ± 0.30 cm, 1.59 ± 1.07 cm on the right respectively. The distance between the ureter of inferior pole of kidney and extra-border of psoas was 2.24 ± 0.67 cm on the left and 2.19 ± 0.73 cm on the right. The distance between crossing of the ureter and iliac展开更多
Objective To study anatomical characteristics of renal pedicle and its clinical application during retroper-itoneoscopic nephrectomy. Methods The imaging,surgical video and clinical data of 278 cases undergoing retrop...Objective To study anatomical characteristics of renal pedicle and its clinical application during retroper-itoneoscopic nephrectomy. Methods The imaging,surgical video and clinical data of 278 cases undergoing retroperitoneoscopic nephrectomy between July 2007 and September 2009 were retrospectively analyzed. The展开更多
Objective To investigate the efficacy of retroperitoneal laparoscopic heminephroureterectomy for duplex kidney anomalies. Methods Retroperitoneoscopic heminephroureterectomy was performed on nine patients,six males an...Objective To investigate the efficacy of retroperitoneal laparoscopic heminephroureterectomy for duplex kidney anomalies. Methods Retroperitoneoscopic heminephroureterectomy was performed on nine patients,six males and three females. The average age of the展开更多
Objective To discuss semilateral supine position for retroperitoneoscopic adrenalectomy. Methods From Jan. 2006 to Dec. 2008,36 patients ( 20 males and 16 females with mean age of 43 years) underwent retroperito-neosc...Objective To discuss semilateral supine position for retroperitoneoscopic adrenalectomy. Methods From Jan. 2006 to Dec. 2008,36 patients ( 20 males and 16 females with mean age of 43 years) underwent retroperito-neoscopic adrenalectomy in 60° - 70°semilateral展开更多
文摘The safety and efficacy of retroperitoneoscopic microwave ablation (MWA) in the treatment of renal hamartoma were evaluated.From July 2007 to July 2009, a total of 16 cases of renal hamartoma were treated with retroperitoneoscopic MWA.Peri-and post-operative findings were observed.Middle-term efficacy was assessed by contrast-enhanced computerized tomography (CT) in follow-up period.All patients received MWA of 1-5 points.The mean operative time was 85 min and the mean blood loss was 65 mL.During a median follow-up of 16 months, no evidence of disease recurrence was observed despite of incomplete ablation in 1 case.Retroperitoneoscopic MWA is a relatively simple procedure with less impact to renal function and less complication.The outcome of middle-term follow-up is satisfactory.Thus, retroperitoneoscopic MWA appears to be a safe and effective technique for renal hamartoma in selected patients.
文摘The occurrence of adrenal crisis after retroperitoneal laparoscopic unilateral adrenalectomy is usually concealed.If not timely diagnosis and treatment,it may cause shock,and even lead to death.It is very difficult to distinguish the clinical manifestations of adrenal crisis from nausea,vomiting,fatigue,gas separation from the lower diaphragm,abdominal pain,hypotension,hypertension,fever and hypothermia after operation.This makes it very difficult to identify and diagnose adrenal crisis early.This article mainly discusses the early recognition,diagnosis and treatment of adrenal crisis after unilateral adrenalectomy by retroperitoneoscope.
文摘Objective: To study the Laparoscopic kidney cancer after Radical prostatectomy, Laparoscopic Radical Nephrectomy, LRN) stress index, tumor markers, and renal function in patients with kidney cancer. Methods: A total of 80 patients with renal cancer treated in our hospital were randomly divided into control group and study group (40 patients in each group). The changes of stress index, tumor marker and renal function before and after operation were compared between the two groups. Results: After operation, stress index, tumor marker and other indicators in both groups were significantly reduced, while the levels of FT3 and FT4 in patients undergoing retroperitoneal laparoscopic radical nephrectomy were significantly lower than those in the control group. After laparoscopic radical resection, tumor inflammatory factors such as CA50, CEA and CA125, as well as inflammatory factors such as TNF-α, serum cortisol and c-reactive protein (CRP) were significantly reduced compared with the control group. Meanwhile, the decreased levels of blood urea nitrogen (BUN) and blood creatinine (SCr) in the study group were significantly higher than those in the control group, indicating that the recovery of renal function in the study group was better than that in the control group. Conclusions: Compared with open radical nephrectomy, retroperitoneal laparoscopic radical nephrectomy can effectively reduce the stress response, inflammatory factors, inflammatory reaction and tumor markers, and significantly improve the recovery of renal function.
文摘Minimally invasive adrenalectomy has become the main treatment modality for most adrenal lesions.Both laparoscopic transabdominal and retroperitoneoscopic approaches are safe and feasible options,each with respective advantages,including better surgical outcomes,fewer complications,and faster recovery over open adrenalectomy.While open surgery remains a valid modality in treatment of adrenocortical cancer in the presence of some findings such as invasion,robotic platforms,and minimally invasive surgery have gained popularity as technology continues to evolve.Organ preservation during adrenalectomy is feasible in some conditions to prevent adrenal insufficiency.Ablative technologies are increasingly utilized in benign and malignant tumors,including the adrenal gland,with various outcomes.A multidisciplinary team,an experienced surgeon,and a highvolume center are recommended for any surgical approaches and management of adrenal lesions.This review article evaluated recent findings and current evidence on minimally invasive adrenalectomy.
文摘Background: Retroperitoneal laparoscopic nephropexy has been applied to nephroptosis. We investigate the approach and treatment effect of retroperitoneal laparoscopic nephropexy. Methods:?From May 1990 to October 2013, 45 patients with nephroptosis treated in our hospital were retrospectively analyzed. Among them, 25 patients underwent nephropexy (open surgery group), the other 20 patients underwent?retroperitoneal laparoscopic nephropexy (laparoscopic surgery group). In open surgery group,?there were 24 females and 1 male, aged 20 - 35 years. In laparoscopic surgery group, there were 19 females and 1 male, aged 20 - 35 years.?All of them with?nephroptosis of the right kidney were combined with lower back pain or hematuria and underwent intravenous pyelography (IVP) and color?ultrasound?in?orthostatic and supine position for a specific diagnosis. In open surgery group, patients underwent open surgery. Their kidneys were?fully dissociated,?then, the upper and?middle pole of the dorsal kidney was?sutured?with?lumbar fascia?for two stitches for fixation respectively. While in?laparoscopic surgery group,?kidneys were fully dissociated in Gerota’s fascia during laparoscopic surgery, and?the upper pole of the dorsal kidney was sutured?with the?lumbar fascia for?two?stitches using a?2-0 absorbable suture. They were all in the supine position for a week after surgery.?The?body mass index (BMI), operation time, bleeding?amount,?postoperative hospital stay,?wound complication rate and other indicators were compared between two groups. Results:?BMI in open surgery group was 16.77 ± 0.80 kg/m2, BMI in?laparoscopic surgery group was 16.73 ± 0.78 kg/m2, P > 0.05 showed no statistical difference;the operation time in open surgery group was 70.96 ± 10.61 min, that in laparoscopic surgery group was 34.65 ± 4.87 min, P?< 0.001?showed highly statistical significance;the bleeding amount in open surgery group was 20.65 ± 6.48 ml, that in laparoscopic surgery group was 4.85 ± 1.63ml, P < 0.001 showed highly statistical significance;the postoperative hospital stay in open surgery group was 7.54 ± 1.28 d, that in laparoscopic surgery group was 7 d, P > 0.05 showed no statistical difference. In open surgery group, four patients had?wound infection which delayed the healing, and the wound complication rate was 16% (4/25). In laparoscopic surgery group,?wound complications did not appear, the incidence was 0%, X2 = 1.8144, P > 0.05 showed no statistical difference. The mean follow-up visit lasted 1.5 years after surgery (3 months to 2 years), B-mode ultrasound in orthostatic and supine position showed kidneys were in the normal position. Compared with those before surgery, postoperative uncomfortable symptoms completely disappeared in all patients. Conclusions: Retroperitoneal laparoscopic nephropexy has a good effect on?symptomatic?nephroptosis. The two stitches?of suture between the upper pole of the dorsal kidney and the lumbar fascia show?convenient operation, less damage and?faster postoperative recovery, which are better than open surgery.
文摘Objective To discover the anatomical basis of retroperitoneoscopic surgery. Methods Twenty Chinese adult cadavers including 12 men and 8 women were anatomized. The relationship between nerves, vessels of the lateral abdominal wall, retroperitoneal structures and the path of retroperitoneoscopic surgery were measured. Results In male cadavers, the distance between the iliac crest and trigonum lumbale was 4.02±1.26 cm on the left, and 3.83 ± 0.90 cm on the right. The distance between the iliac crest and iliohypogastricus nerve was 0.82 ± 0.13 cm on the left and 0.84±0.08 cm on the right. The distance between the subcostal nerve and Ⅻ rib in the posterior axillary line and midaxillary line was 0.79 ±0.26 cm,1.65± 1.12 cm on the left and 0.78 ± 0.30 cm, 1.59 ± 1.07 cm on the right respectively. The distance between the ureter of inferior pole of kidney and extra-border of psoas was 2.24 ± 0.67 cm on the left and 2.19 ± 0.73 cm on the right. The distance between crossing of the ureter and iliac
文摘Objective To study anatomical characteristics of renal pedicle and its clinical application during retroper-itoneoscopic nephrectomy. Methods The imaging,surgical video and clinical data of 278 cases undergoing retroperitoneoscopic nephrectomy between July 2007 and September 2009 were retrospectively analyzed. The
文摘Objective To investigate the efficacy of retroperitoneal laparoscopic heminephroureterectomy for duplex kidney anomalies. Methods Retroperitoneoscopic heminephroureterectomy was performed on nine patients,six males and three females. The average age of the
文摘Objective To discuss semilateral supine position for retroperitoneoscopic adrenalectomy. Methods From Jan. 2006 to Dec. 2008,36 patients ( 20 males and 16 females with mean age of 43 years) underwent retroperito-neoscopic adrenalectomy in 60° - 70°semilateral
