55例单切口泌尿系腹腔镜手术回顾分析

目的:总结单切口腹腔镜泌尿外科手术的手术经验与体会,探讨单切口腹腔镜手术在泌尿外科的应用价值。方法:回顾分析2009年6月至2011年10月为55例患者行单切口腹腔镜手术的临床资料,其中前列腺癌根治术10例,肾部分切除术6例,肾上腺切除术20例,肾盂成形术3例,输尿管切开取石术9例,输尿管膀胱再植术3例,肾囊肿去顶减压术4例。结果:55例手术均获成功,无一例中转开放或中转普通腹腔镜手术。手术时间68～320 min,平均(105±38)min;出血量10～120 ml,平均(60±35)ml,无输血病例;平均住院(6.1±2.4)d,术后随访1～24个月,无肾脏萎缩及肿瘤局部复发、远处转移征象。结论:单切口腹腔镜手术安全、可行,具有微创、美观等优点,但操作难度较传统腹腔镜手术增加,应谨慎把握手术适应证,术者具备扎实的普通腹腔镜操作技术方可开展。

Application of laparoendoscopic single-site surgery in urological surgery: with a report of 55 cases

Objective： To discuss the clinical application of laparoendoseopic single-site surgery（LESS） in urological surgery.Methods： The clinical data of 55 patients underwent LESS from Jun.2009 to Oct.2011 were analyzed retrospectively.Results： Among the 55 patients,radical prostatectomy were performed in 10 cases,partial nephrectomy in 6 cases,adrenalectomy in 20 cases,renal pelvis angioplasty in 3 cases,ureterolithotomy in 9 cases,ureteral reimplantation in 3 cases,renal cyst decortication in 4 cases.All operation were performed successfully,none was transfered to the traditional laparoscopic or open surgery.The operative time was 68-320 min,mean operative time was（105 ± 38） min.Bleeding loss was 10-120 ml,mean blood loss was（60 ± 35） ml.No patient was received a blood transfusion during operation.The average hospital time was（6.1 ± 2.4） days.All patients were followed up from 1 to 24 months.Conclusions： LESS is not only safe and feasible but also minimally invasive and cosmetic.But the surgical procedures are more difficult than traditional laparoscopic surgery.The operative indications should be controlled carefully and it should be performed by experienced laparoscopic surgeons.