后腹腔镜在肾切除术中的应用分析

目的探讨后腹腔镜在各类肾切除中的应用及疗效分析。方法回顾性分析136例经腹膜后腹腔镜行肾切除术治疗的各类肾脏疾病患者的临床资料,其中肾结核肾切除术10例、肾癌根治性肾切除术56例、无功能肾切除术34例、肾上腺切除术24例、巨大肾积水肾切除术12例。结果 136例手术均获成功;手术时间76～198min,平均（162±10）min;术中出血量15～280mL,平均（47±12）mL;术后并发症（包括皮下气肿、腹膜损伤、皮下淤血、漏尿等）发生率为11.3%,其中腹膜损伤立即缝合,漏尿予留置尿管、半卧位引流5～7d后恢复,皮下气肿、皮下淤血术后自行吸收。术后恢复良好,5～7d后可下床活动。56例肾恶性肿瘤患者随访3～9个月,均未发现复发或转移。结论经腹腔镜行肾切除术治疗安全可行,具有创伤小、术后恢复快、并发症少及住院时间短等优点。但对肾恶性肿瘤中远期疗效尚需进行长期随访及进一步观察研究。

Application and analysis of retroperitoneal laparoscopic nephrectomy

Objective To explore the application and effect for retroperitoneal laparoscopy in surgery of all various of nephrectomy.Methods Retrospectively analysed the clinical data of 136 patients with different renal diseases in our hospital,all of them were treated with retroperitoneal laparoscopic nephrectomy,included 10 patients with renal tuberculosis,56 patients with renal carcinoma,34 cases of removal of non-functioning kidney,24 cases of adrenalectomies,12 cases with hydronephrosis.Results All 136 surgeries were successfully completed.The mean operation time was（162±10）（76-198）min and the mean estimated blood loss was（47±12）（15-280）mL.There was no severe complication during perioperative period.16 patients with maligant renal carcinoma afetr operation had over 3-9 months flowed-up,results showed no reccurence or meastasis.Conclusion Retroperitoneal laparoscopic nephrectomy is safe and effective and has advantages of minimal invasion,short hospital stay and short-time recovery.But medium-long period therapy effect of this kind of operational for maligant renal carcinoma will need chronic follow-up and more further researches and investigations.