后腹腔镜术并发胸膜损伤诊治体会

目的探讨后腹腔镜手术并发胸膜损伤的原因及处理方法。方法回顾性分析105例后腹腔镜泌尿外科手术的临床资料。其中2例并发胸膜损伤,给予降低后腹腔内压力,尽快结束手术,手术结束前抽空后腹腔及胸腔内气体,妥善放置引流管等处理。结果胸膜损伤发生率为1.9%(2/105),2例患者术后患者恢复良好,术后3d复查胸片,胸腔积气基本消失。结论后腹腔镜手术中损伤胸膜,无须立即行改行开放手术,保守治疗可获得良好效果,值得临床推广应用。

Experience in the diagnosis and treatment of pleural injury during retroperitoneal laparoscopic operation

Objective To investigate the cause and processing method of pleural injury during retroperitone-al laparoscopic operation. Methods The clinical data of 105 cases of retroperitoneal laparoscopic operation in the Department of urology was retrospectively analyzed, of which 2 cases were complicated with pleural injury. We reduced the intraperitoneal pressure, evacuated the gas in the peritoneal and pleural before the end of operation, properly placed the drainage tube, and ended the operation as soon as possible. Results The incidence of pleural injury was 1.9% （2/105）. The 2 patients recovered well after the operation, and the chest radiograph repeated and the thorax pneu-matosis disappeared 3 days later. Conclusion For treating pleural injury during retroperitoneal laparoscopic operation, we do not need to immediately convert to open operation. Conservative treatment can obtain good effect and should be extended in clinical practice.