摘要
目的评价腹膜后腹腔镜肾部分切除术的可行性及临床价值。方法39例肾占位患者行后腹腔镜肾部分切除术，肿瘤直径2．5—4．6cm，平均3．8cm。手术时，所有的患者都行肾蒂血管阻断。评价手术时间、肾蒂阻断时间、出血量、并发症及肿瘤复发情况。结果38例手术顺利完成，1例中转开放，阻断肾蒂时间为21～36min，平均26min，手术时间70～145min，平均102min，术中出血60～900ml，平均105ml。术后病理为32例肾癌，7例错构瘤。术后并发尿漏1例，放置双J管治愈。术后住院7～15d，平均10d，随访3～36个月无肿瘤复发。结论腹膜后腹腔镜肾部分切除术患者创伤小，术后康复快，值得临床推广。有可能代替开放手术，可能成为治疗肾脏局限性占位病变的首选治疗方法。
Objectives To evaluate the feasibility and the clinical value of retroperitoneal laparoscopic par- tial nephreetomy. Methods Thirty - nine patients with renal tumor were treated with retroperitoneal laparoscopic surgery. The tumor size was 2.5 - 4.6cm （mean was 3.8 cm） in diameter. During operation, renal circulation was tem- porarily interrupted in all patients. The operative time, intraoperative renal interrupted time, blood loss, postoperative complications and recurrence were observed and evaluated. Results Thirty - eight operations were successfully accomplished,the other 1 case was converted to open surgery. The intraoperative renal interrupted time was 21 - 36min （ mean was 26min）, The operative time was 70 - 145min （ mean was 102min）. And the intraoperative blood loss was60 - 900ml（ mean was 105ml ）. Pathological examination showed the renal cell carcinomar 32 cases and the hamartoma 7 cases. The postoperative complication have one case leakage of urine, placed double J tube cured . Postoperative hospitalization time was 7 - 15d（ mean was 10d）. No tumor recurrence was found during a follow - up of 3 - 36 months. Conclusions Retroperitoneal laparoscopie partial nephreetomy is worthy to be extended with advantages of mini - invasion and rapid recovery. May replace open surgery , become frist choice therapeutic method for renal limitations tumor.
出处
《国际泌尿系统杂志》
2012年第6期732-735,共4页
International Journal of Urology and Nephrology
