小切口后腹腔镜辅助手术治疗简单上尿路疾病

目的探讨小切口后腹腔镜辅助手术治疗简单上尿路疾病（肾囊肿、输尿管上段结石、肾盂输尿管连接部梗阻）的临床价值。方法对23例简单上尿路疾病患者（肾囊肿12例,输尿管上段结石6例,肾盂输尿管连接部梗阻5例）,采用连续硬膜外麻醉,行经腰部小切口,将30°腹腔镜镜头置于切口边缘,并在其辅助下在后腹腔完成手术。结果 23例手术均获成功,术中及术后未发生并发症。手术切口为长度4～6cm,平均4.5cm;手术时间为30～120min,平均50min;术中出血量为20～70ml,平均45ml;术后住院7～8d,平均7.4d。结论小切口后腹腔镜辅助手术治疗简单上尿路疾病结合了开放手术与腹腔镜手术的优点,使手术创伤减小、手术难度降低、手术时间缩短,是一种安全、有效、微创的方法 。

Mini-Incision Assisted by Retroperitoneal Laparoscopy in the Treatment of Simple Upper Urinary Tract Diseases

Objective To investigate the clinical value of mini-incision assisted by retroperitoneal laparoscopy for simple upper urinary tract disease（renal cyst,upper ureteral calculi,ureteropelvic junction obstruction）.Methods Under continuous epidural anesthesia,twenty-three patients with simple upper urinary tract diseases（12 cases with renal cyst,6 cases with upper ureteral calculi,5 cases with ureteropelvic junction obstruction）were operated through a lumbar mini-incision.In the operation,the 30°laparoscopy lens was placed in incision edge,and assisted in the retroperitoneal.Results Mini-incision assisted by retroperitoneal laparoscopy was performed successfully on all 23 cases.No case occurred complication.The length of incision was 4-6 cm（mean,4.5 cm）,the operating time was 30-120 min（mean,50 min）,the blood loss was 20-70 ml（mean,45 ml）,and the postoperative hospitalization was 7-8 d（mean,7.4 d）.Conclusion Mini-incision assisted by retroperitoneal laparoscopy in the treatment of simple upper urinary tract disease combinated the advantage of open surgery and laparoscopic operation.It has the advantages of minimal invasion,simple operation procedures and short operation time.It is a safe,effective,and minimally invasive therapy.