后腹腔镜积水无功能肾切除术（附5例报告）

目的探讨后腹腔镜积水无功能肾切除术的手术方法和效果。方法对5例积水无功能肾患者行后腹腔镜积水无功能肾切除术。腰部3个Trocar穿刺入路，手指法建立后腹膜气腹，游离出部分病变肾脏后先肾脏切开一小口，吸净积水肾内的积水，然后再游离肾脏，暴露肾蒂后，用钛夹或Hem-olock夹闭肾蒂并切断，将积水无功能肾切除并置入标本袋后取出。结果5例手术均获得成功，手术时间为150～300min，平均为170min。术中出血10～80ml，平均30ml。引流管于术后2～3d拔除，无大出血、感染、腹膜破裂、腹腔脏器损伤等并发症。结论后腹腔镜积水无功能肾切除术是一种微创、安全、有效、恢复快的术式，必将成为此类疾病治疗的首选方法。

Retroperitoneo scopic nephrectomy on the treatmet of non-functioning kidney with hydronephrosis(Report of 5 cases)

Objective To evaluate the operation method and results of retroperitoneoscopic nephrectomy on the treatment of non-functioning kidney with hydronephrosis.Methods Retroperitoneoscopic nephrectomy was performed in 5 cases with nonfunctioning kidney with hydronephrosis.The retroperitoneal cavity were established with the fingers separating method.Afterwards ,3 Trocars were inserted through lumbar ports,the kidney was liberated partially,and made a small hole,the intrarenal fluid was drawn out.Then the kidney was liberated fully,the renal pedicle were exposed,and blocked with titanium clips or Hem-o-lok and then cut off,the non-functioning kidney was taken out in a specimen bag.Results The 5 operations were successful.The mean operative time was 170 min(150-300 min),and blood loss was 30 ml(10-80 ml).Drainage tube was removed 2-3 days after operation,we have not found any massive hemorrhage,infection,peritoneum rupture,intraabdominal visceral injury,and other severe complications.Conclusion Retroperitoneoscopic nephrectomy for non-functioning kidney with hydronephrosis is proved to be ninimal invasive,safe,effective,and rapid recovery.It would become the first choice for this kind of disease.