摘要
目的:探讨采用自制套管施行单孔后腹腔镜肾部分切除术的方法。方法:2009年5～11月采用单孔后腹腔镜施行肾部分切除术6例,其中男3例,女3例,平均年龄(54.3±12.6)岁。原发病为小肾癌4例,肾错构瘤2例;病灶位于右侧3例,左侧3例。手术采用气管内麻醉,经腹膜后入路。取患侧向上的全侧卧位,取肋下3～4 cm切口切开法进入腹膜后间隙,然后置入自制套管,通过此套管置入5 mm电子腹腔镜及常规操作器械进行肾手术。肾动脉阻断后行肾部分切除,创面缝扎止血。结果:6例均在单孔后腹腔镜下顺利完成手术。手术时间(140.0±44.3)min;肾热缺血时间(24.5±4.6)min;出血量(108.3±39.7)ml。无术中腹膜破裂、大出血、周围脏器损伤、术后继发出血、切口感染、肠梗阻等并发症。病理检查证实切缘均为阴性。术后(5.0±0.9)天出院。结论:应用自制套管对于选择性病例施行单孔后腹腔镜肾部分切除手术安全可行,切口创伤小,切口美观。
Objective： To evaluate retroperitoneal laparoscopic partial nephrectomy with homemade single-access port. Methods： From May 2009 to November 2009, 6 cases with renal diseases, mean aged 54.3 years, 3 males and 3 females, were performed retroperitoneal laparoseopic partial nephrectomy with homemade single-access port. The primary renal diseases were 4 cases, of renal cell carcinoma and 2 cases of hamartoma, which located in left side in 3 patients, and right side in 3 patients. The operations were done in lateral decubitus under general anaesthesia. A 3-4 cm subcostal ineision was made. And retroperitoneal working space was setup by dilation. Then the homemade single-access port was set in the incision. Laparoseope （Olympus 5 mm） and conventional in- struments were applied, and the kidney was separated laparoscopically. After the renal artery was controlled, the partial nephrectomy was done, sutured the wound to stop bleeding. Results： Six eases of retroperitoneal laparoscopic partial nephrectomy were all completed with homemade single-access port. The operation time was （140. 0 ±44.3）min; the mean renal ischemia time was （24.5±4.6）min; the estimated blood loss was （108. 3±39.7）ml. No major complication such as intraoperative peritoneal rupture, bleeding, peripheral organ injury, postoperative hemorrhage, wound infection, bowel obstruction occurred. Pathology showed negative surgical margins in all cases. The postoperative hospital stay was （5.0±0.9） d. Conclusions： Retroperitoneal laparoseopic partial nephreetomy with homemade single access port was feasible and safe, associated with the advantages of minimal invasion and cosmetic benefit.
出处
《临床泌尿外科杂志》
北大核心
2010年第3期168-171,175,共5页
Journal of Clinical Urology
关键词
肾疾病
腹腔镜
单孔
肾部分切除术
kidney diseases
laparoscopic surgery single port
partial nephrectomy
