后腹腔镜下肾切除术

目的 探讨后腹腔镜下肾切除术的临床应用价值.方法 回顾性分析我院自2008年5月至2009年9月68例后腹腔镜下肾切除术患者的临床资料.首先清除腹膜外脂肪,打开肾周筋膜,沿腰大肌方向分离至肾蒂,游离肾动脉、肾静脉及输尿管,并用Hem-o-lok夹闭后离断之,继续游离肾脏.延长腰部切口,将患肾取出.结果 所有患者除1例因肾蒂周围粘连较严重,无法分离中转开放外,均获成功,未发生周围脏器及大血管损伤等严重并发症.手术时间60～120 min,平均90 min,失血量50～150 ml,平均100 ml.术后2～3 d拔除创腔引流管.术后平均住院时间8～10 d,平均9 d.平均随访5个月,对侧肾功能正常.结论 后腹腔镜肾切除术损伤小,住院时间短,患者恢复快.Abstract：Objective To investigate the clinical efficacy of retroperitoneal laparoscopic surgery in nephrectomy. Methods The way was retrospective analysis of 68 patients who were our in-patients and took the operation of retroperitoneal laparoscopic nephrectomy from May 2008 to September 2009. First of all, cleaning the extraperitoneal fat and then open the perirenal fascia,freeing the tissue along with psoas to renal pedicle and next freeing renal artery,renal vein and ureter,occlusing them with Hem-o-lock and then disconnected them,continuing freeing the kidney. Elongating the incision in the waist,taking out the kidney with tuberculosis. Results Only one case in all patients changed the operation type into opening since the adhesion around the renal pedicle was so serious that the target couldn't be freed clearly. All operations turned out to be successful and had no serious complications like the injury of large vessels and important organs around. Operation times are among 60 mins to 120 mins, 90 mins on average and blood losses are between 50 ml and 150 ml, 100 ml on average. Taking off the drainage tube 2 to 3 days after operations. The hospital stays after operations were 8-10 days, 9 days on average. The average follow-up period was 5 months and the function of the kidney in the other side was normal in this period. Conclusions Retroperitoneal laparoscopic nephrectomy has advantages of minimal invasion,short hospital stay and rapid recovery.

Retroperitoneal laparoscopic surgery in nephrectomy

Laparoscopy Renal Nephrectomy