经腹腹腔镜半肾切除术治疗成人重复肾畸形(附12例报告)

目的:探讨经腹腹腔镜半肾切除术治疗成人重复肾畸形的方法、可行性和临床疗效。方法:回顾我院2010年6月~2014年1月采用经腹腹腔镜行重复肾畸形上半肾切除术治疗12例患者,其中男4例,女8例,年龄18~56岁,平均36岁。左侧9例,右侧3例,12例重复肾畸形患者均为上半肾病变。结果:12例手术均获成功,无中转开放手术。手术时间60~120min,平均90min;术中出血量20~150ml,平均50ml;术后肠道功能恢复时间1~3d,平均2d;术后24~72h进流食,3~4d拔除引流管;术后住院时间7~9d,平均8d;术后随诊6~15个月,平均9个月;术后3、6个月内均行IVU检查,下半肾功能均正常,原发症状消失。结论:经腹腹腔镜半肾切除术治疗成人重复肾畸形具有手术视野开阔、住院时间短、创伤小、恢复快等优点,是治疗成人重复肾畸形安全有效的手术方法。

Transperitoneal laparoscopic heminephrectomy for duplex kidney in adults（Repot of 12 cases）

Objective：To explore the technique,feasibility and clinical efficacy of transperitoneal laparoscopic heminephrectomy for duplex kidney in adults.Method：Twelve cases of duplex kidney cured by transperitoneal laparoscopic heminephrectomy from June 2010 to January 2014 were reviewed including four males and eight females.The mean age was 36（range,18-56）years.Nine duplex kidneys were on the left side and three were on the right side.All duplex kidneys were on the upper pole.Result：All patients underwent operations successfully without conversion to open surgery.The mean surgical time was 90（range,60-120）min.The mean blood loss was 50（range,20-150）ml.The mean postoperative intestinal function recovery time was 2（range,1-3）days.Patients restarted a liquid diet 24-72 hours postoperatively.The extubation time was 3-4days postoperatively.The mean postoperative hospital stay was 8（range,7-9）days.The mean follow-up period was 9（range,6-15）months.The examination of IVU was performed at postoperative three and six months.Patients＇ renal functions were normal and the primary symptoms disappeared.Conclusion：Transperitoneal laparoscopic heminephrectomy is a safe,effective technique for duplex kidney in adults,with some advantages of wide vision,short hospital stay,minimal invasion and quick recovery.