摘要
目的:介绍腹腔镜肾切除术治疗巨大肾积水的临床经验。方法:2005年1月～2009年2月采用腹腔镜经后腹腔途径行肾切除术治疗巨大肾积水患者5例,男2例,女3例,平均年龄39(18～57)岁。5例均为肾盂输尿管连接部狭窄,其中左侧3例,右侧2例。观察手术时间、术中出血量、住院天数、并发症及手术效果。结果:5例均成功施行腹腔镜肾切除术,平均肾积水量4 500(3 000～11 000)ml,平均手术时间85(60～115)min,术中平均出血量45(10～80)ml。其中1例术前放置输尿管支架管引流尿液并控制感染,4例术中需切开肾皮质吸出部分或全部积水,以降低肾张力。结论:巨大肾积水行腹腔镜肾切除术安全、可行,通过放置输尿管支架管或切开肾皮质放出部分或全部积水对患肾减压有助于手术操作。
Objective： To evaluate the clinical effect of laparoscopic nephrectomy for giant hydronephrosis. Methods：From January 2005 to February 2009,5 patlents（2 men and 3 women） with giant hydronephrosis underwent retroperitoneal laparoscopic nephrectomy. The mean patient age was 39 （range 18 to 57）years, All patients suffered from ureteropelvic junction obstruction, which 3 cases in the left side 2 cases in right side . The operative time, estimated blood loss, postoperative hospital stay, complications and the time of convalescence were recorded. Results：The operations were successfully performed in all patients. The average fluid was 4 500（3 000-11 000）ml. The mean operative time was 85（60-115）min. The mean estimated blood loss was 45（10-80）ml. 1 case of ureteral stents placed before surgery and to control drainage of urine infection, 4 cases of renal cortical aspiration need to cut some or all of the water, to reduce the renal tension. Conclusions：Giant hydronephrosis laparoscopic nephrectomy is safe and feasible, through the placement of ureteral stents or cut renal cortical release of some or all of stagnant water on the risk of kidney contribute to operative decompression.
出处
《临床泌尿外科杂志》
北大核心
2010年第6期444-445,450,共3页
Journal of Clinical Urology
