泌尿外科经腹膜后行二次腹腔镜手术的探讨

目的 探讨泌尿外科二次经腹膜后行腹腔镜手术的可行性.方法 2009年1月～2013年1月我院对5例有同侧开放或腹腔镜经腹膜后途径手术者经腹膜后途径行二次腹腔镜手术,两次手术间隔0.6～10年,平均2.4年.第2次手术均取经腹膜后入路.结果 手术均获成功,手术时间55～300min,平均120 min;术中出血量60～500m1,平均140ml;术后住院5～10 d,平均7天.1例腹膜损伤,无腹腔内脏器损伤.5例随访4～12个月,平均6个月,恢复良好,肾囊肿及肿瘤未见复发,未见重大并发症发生.结论 随着腹腔镜手术技巧的提高,对于合适的病例再次行后腹腔镜手术是可行的.

Experience of retroperitoneal laparoscopic re-operation in urology

Objective To investigate the feasibility of re-operation by retroperitoneal laparoscopy in urology.Methods Five patients underwent retroperitoneal laparoscopy for a second operation from January 2009 to January 2013 in our hospital were analyzed retrospectively.All the patients had received an ipsilateral operation by open or retroperitoneal laparoscopic approaches.The interval between the two operations ranged from 0.6 to 10 years with a mean of 2.4 years.Retroperitoneal laparoscopic approach was employed in all the patients for the second operation.Results The procedure was completed in all the patients within 55-300 min （mean,120 min）.The intraoperative blood loss was 140 ml in average （ranged from 60 to 500 ml）.The patients were discharged from hospital in 5 to 10 days （mean,7 days） after thesecond surgery.All patients were followed up for 4～ 12 months（mean,6 months） and no major complication was observed.Conclusion Re-operation by retroperitoneal laparoscopy is feasible in properly selected cases with skilled and experienced hands.