单纯性腹腔镜肾切除术治疗良性无功能肾22例报告

目的:总结单纯性腹腔镜肾切除术治疗良性无功能肾的临床应用经验。方法:回顾分析2003年9月至2009年11月施行单纯性腹腔镜肾切除术治疗22例良性无功能肾患者的临床资料。先天性肾盂输尿管连接处狭窄12例,输尿管结石6例,慢性肾盂肾炎2例,肾结核2例。结果:22例手术均获成功,无中转开放手术。手术时间65~180min,平均90min,术中出血25~150ml,平均55ml。住院4~12d,平均5d。无严重并发症发生及输血病例。1例经腹膜后途径患者术后拔除引流管后局部形成腹膜后血肿,再次在B超引导下置管引流。结论:单纯性腹腔镜肾切除术治疗良性无功能肾安全、微创,耐心细致的手术操作和对不同疾病采取个性化的治疗方案是手术成功的关键。

Simple laparoscopic nephrectomy for benign nonfunctioning kidneys:with a report of 22 cases

Objective:To review the clinical experience of simple laparoscopic nephrectomy for benign nonfunctioning kidneys.Methods:The clinical data of 22 cases of simple laparoscopic nephrectomy for benign nonfunctioning kidneys from Sep.2003 to Nov.2009 were retrospectively reviewed.The primary affections were congenital ureteropelvic junction stenosisin 12 patients,ureteral stones in 6 cases,chronic pyelonephritis in 2 patients and renal tuberculosis in 2 cases.Results:The operations of 22 cases were successfully performed without severe operative complications.The operation time ranged from 65 to 180min(mean 90min),the intraoperative blood loss ranged from 25 to 150ml(mean 55ml) and the postoperative hospital stay ranged from 4 to 12d(mean 5d).There was no blood transfusions or conversion.1 case via retroperitoneal approach developed retroperitoneal hematoma after the drainage tube was removed,ultrasound guided percutaneous drainage was performed later.Conclusions:Simple laparoscopic nephrectomy for benign nonfunctioning kidneys is safe and minimally invasive.The doctor's patience,carefulness and individualization of surgical technique play the key role in the success of the operation.