腹膜后腹腔镜手术在泌尿外科中的应用(附62例报告)

目的：探讨腹膜后腹腔镜在泌尿外科中的应用。方法：2001年4月～2002年12月行经腹膜后途径腹腔镜手术62例，其中肾癌根治性肾切除1例，肾盂癌肾输尿管全切1例，巨大肾积水单纯性肾切除3例，肾上腺肿瘤切除13例，输尿管切开取石5例，肾囊肿去顶37例，多囊肾去顶减压2例。结果：62例手术均获得成功。手术时间：肾囊肿去顶术20～90min(平均42min)，单纯性肾切除术135min，根治性肾切除术150min，肾输尿管全切185min，肾上腺切除术30～110min(平均75min)，输尿管切开取石术100～130min。术后住院2～7d(平均4d)，肠功能恢复时间平均为25h。术中无大出血(平均出血量约65ml)、脏器损伤、气体栓塞等严重并发症，无二次手术病例。术后随访1～20个月，所有病人症状均消失或好转，未见原发病复发。结论：腹膜后腹腔镜手术具有切口小、出血少、损伤轻、恢复快、并发症少等优点，具有良好的应用前景。

Application of retroperitioneal laparoscopes in uroloic surgery ( report of 62 cases)

Objective To explore the clinic value of the retroperitoneal laparoscopes in urologic surgery. Methods From Apr 2001 to Dec 2000, 62 retroperitoneal laparoscopic operations were performed, including lease of radical nephrectomy, 1 case of nephroureterectomy, 3 cases of nephrectomy, 13 cases of adrenalecto-my, 5 cases of ureterolithotomy, 37 cases of unroofing of renal cysts and 2 cases of multiple cystic decortica-tions. Results Sixty-two operations were successfully. The operating time was 20 -90mins in unroofing of renal cysts (average 42mins) , 135mins in nephrectomy, 150 mins in radical nephrectomy, 185 mins in nephroureterectomy, 30 - 110mins in adrenalectomy (average 75min). 100-130mins in ureterolithotomy. The average volume of bleeding was 65ml. The average hospitalization was 4 days (range 2 - 7d) , the mean recovery time of intestinal function was 25h, there was no serious complications in perioperative period. Conclusion The merits of retroperitoneal laparoscopic surgery are small incision, minimal injury, less bleeding and postoperative quick recovery. The retroperitoneal laparoscopes will play a more important role in urologic surgical procedures in the future.