后腹腔镜技术在肾脏切除中的应用

目的:探讨后腹腔镜肾切除术的临床应用价值.方法:回顾性分析我院后腹腔镜肾切除术17例患者的临床资料.结果:17例均完整切除患肾,术中中转开放手术2例.手术时间110～210 min,平均140 min;术中出血量50～150 mL,平均100 mL.术中均无输血.发生腹膜损伤2例,未发生气胸,术后穿刺孔出血1例,经处理后痊愈,未出现切口感染.平均住院7～9天,全组无死亡患者,随访5～24个月未出现特殊并发症.结论:采用后腹腔镜进行肾切除术,能直接、迅速进入手术野、显露血管快,解剖清晰,出血少,损伤轻,恢复快.

Application of retroperitoneal laparoscopic technique in nephrectomy

Objective：To explore the clinical application value of retroperitoneal laparoscopic nephrectomy.Methods：17 cases of retroperitoneal laparoscopic nephrectomy from May 2006 to October 2009 were retrospectively discussed.Among them,11 cases were male and 6 cases were female and their average age was 62 years old.The resections were in the left for 10 cases and in the right for 7 cases,which were completed by retroperitoneal laparoscope.Results：Complete resections of the ill kidney were performed in 17 cases,among which a conversion to open surgery was needed in 2 cases.The surgeries lasted 110 min to 210 min and the average time was 100 min.The blood loss during operation was 50ml to 150ml and the average was 100ml without blood transfusion during all surgeries.Peritoneal damage was in 2 cases,but no pneumothorax.Hemorrhage of puncture hole after operation was in 1 case,which was healed by processing without wound infection.The median length of hospital stay was 7-8d.There was no dead case after operation.With all patients followed up for 5-24 months,no further complication was found.Conclusion：Retroperitoneal laparoscopic surgery for nephrectomy could be fast for blood vessel exposing with clear layer of anatomy.It has the advantages of less trauma,less hemorrhage and rapid recovery,so it is worth expanding clinically.