无TriPort的单孔后腹腔镜根治性肾切除

目的 探讨使用常规腹腔镜器械行经后腹膜腔无TriPort的单孔根治性肾切除术的临床应用及疗效.方法 回顾分析北京友谊医院2011年12月至2012年9月收治的10例肾细胞癌患者,10例患者中男6例,女4例.年龄32 ～ 68岁,平均47.5岁.癌肿最大径3.5 ～6.4 cm,平均5.2 cm.癌肿位于肾上极2例,中极5例,下极3例.在腋中线髂嵴上3 ～4 cm做直径长约3 cm的半圆形切口,应用常规腹腔镜器械行无TriPort的单孔后腹腔镜根治性肾切除术.结果 10例患者均成功手术,无1例中转开放手术.手术时间120～180 min,平均146 min.出血量约100 ～200 ml,平均150 ml.术后引流管留置时间1～4d,平均住院时间7～9d,所有患者术后未使用镇痛药物.术后随访3～ 12个月,未见肿瘤复发.结论 应用常规腹腔镜器械行经后腹膜腔无TriPort的单孔腹腔镜根治性肾切除术安全有效,不仅具有传统腹腔镜手术的优点,还可以减少手术费用及手术创伤,并具有一定美容效果.

The clinical experience of single-port retroperitoneal laparoscopic radical nephrectomy without TriPort instruments

Objective To evaluate the application value and efficacy of single-port retroperitoneal laparoscopic radical nephrectomy with conventional laparoscopic instruments and without TriPort.Methods Ten cases treated in Beijing Friendship Hospital from December 2011 to September 2012 were assigned to undergo singleport retroperitoneal laparoscopic radical nephrectomy.There were 6 male patients and 4 females.The patients age range from 32 to 68 years and with an average age of 47.5 years.The diameter of tumor was 3.5 cm to 6.4 cm with an average diameter of 5.2 cm.There were 2 patients with the tumor located in the superior side of the renal,5 patients with the tumor located in the middle side of the renal and 3 patients located in the inferior side.A single 3 cm arch incision was situated in midaxillary line 3 to 4 cm above the iliac crest and all patients had undergone singleport retroperitoneal laparoscopic radical nephrectomy with conventional laparoscopic instruments and without TriPort.Results All the 10 patients were successfully undergone laparoscopic radical nephrectomy.The operative time ranged from 120 to 180 min with the mean operative time 146 rain.Estimated blood loss were 100 to 200 ml with the mean blood loss 150 ml.The drainage time was 1 day to 4 days and post-operative hospital stays were 7 days to 9 days.All patients had no analgesic drug after operation.Condusions Single-pert retroperitoneal laparoscopic radical nephrectomy with conventional laparoscopic instrument and without TriPort is a safe and effective therapeutic method for renal cell carcinoma.It has the advantage of traditional surgery,with less expense and trauma,also it has the benefit of cosmetic result.