腹腔镜肾切除术两种不同入路的比较

目的比较腹腔镜肾切除术经腹腔入路与经后腹入路的差异。方法2002年6月~2003年12月应用腹腔镜行肾切除术48例,均为重度积水无功能肾患者。完全随机分组,其中23例采用经腹腔入路,25例采用经后腹膜腔入路。随访3个月~1年,作统计分析。结果48例手术均获成功。手术时间经腹腔入路组120~250 min,平均170 min,经后腹腔入路组80~180 min,平均110 min(P<0.05);术中出血量腹腔入路组平均80ml,经后腹腔入路组平均30 ml(P<0.05);经腹腔入路组出现2例阴囊皮下气肿,经后腹腔入路组发生1例腹膜穿孔。结论在重度积水无功能肾的腹腔镜肾切除术中,经后腹腔入路较经腹腔入路更可靠、安全、易操作。

Comparison between two different routes in laparoscopic nephrectomy

Objective: To compare the differences between transperitoneal laparoscopy and retroperitoneal laparoscopy. Methods: From Jun 2002 to Feb 2004, laparoscopic nephrectomy were carried out for 48 cases. All cases were served hydronephrosis which were completed random divised to 2 groups. Twenty-three cases were carried out transperitoneal laparoscopy (Group A) and 25 cases were retroperitoneal laparoscopy (Group B). Follow-up 3 months to 1 year and perform statistical analysis. Results: All operations were successful. The operation time in Group A varied from 120 min to 250 min (average 170 min); Group B varied from 80 min to 180 min (averge 90 min) (P<0.05). The average amount of bleeding in Group A was 80 ml and Group B was 30 ml (P<0.05). The main complications were 2 cases of subcutaneous emphysema of scrotum in Group A and 1 case of peritoneal injury. Conclusions: Retroperitoneal laparoscopy is safer, more reliable and easier manipulate than transperitoneal laparoscopy.