后腹腔镜保留肾单位手术切除较大肾脏错构瘤

目的：探讨后腹腔镜保留肾单位手术切除较大肾脏错构瘤的病例选择、手术方法和临床效果.方法：共15例确诊为肾脏错构瘤患者.其中男6例,女9例,年龄26～59岁.平均39岁.左侧6例,右侧9例.肿瘤直径5 cm×7 cm～16 cm×12 cm,最大直径平均8 cm.所有患者均行后腹腔镜保臂肾单位手术.观察手术时间、术中出血量、术后住院天数和术中术后并发症及手术效果.结果：15例手术全部成功.平均手术时间为70（55～95）min,平均热缺血时间 24（13～35）min.平均出血量35（20～60）ml.平均术后住院时间为7（6～9）天.围手术期无并发症.结论：后腹腔镜肾保留肾单位手术对一些较大的肾错构瘤患者仍然安全可行,创伤小,患者恢复快,值得选择性地推广使用.

Retroperitoneal Laparoscopic Nephron-Sparing Surgery for Large Renal Angiomyolipoma

Objective：To discuss the indication and evaluate the feasibility and clinical efficacy of retroperitoneal laparoscopic nephron-sparing surgery for large renal angiomyolipoma. Methods： Between June 2007 and January 2010, 15 cases with renal angiomyolipoma underwent laparoscopic nephron sparing surgery through retroperitoneal approach. Six patients were male.9 patients were female. The mean age was 39 years old（from 26 to 59 years old）. Six cases were on left side, and nine on the right. Tumor diameter was 5 cm × 7 cm -16 cm × 12 cm,mean tumor size in the maximum diameter was 8 cm. Tumor resection was achieved mainly by Harmonic Scalpel. The operative time, blood loss, complications during operation and the operative efficacy were observed. Results： All procedures were technically successful without open conversion. Mean operative time was 70 minutes（from 55 min to 95 rain）, mean warm ischemia time was 24 min （from 13 min to 35 min） and mean blood loss was 35 ml （from 20 min to 60 ml）. Mean hospital stay after operation was 7 days （from 6 to 9 days）. No intraoperative or postoperative complication occurred. Conclusions： Our results indicate that retroperitoneal laparoscopic nephron-sparing surgery represents a feasible option for selective patients with large renal angiomyolipom. This procedure could provide a minimally invasive procedure resulting in less morbidity, improved cosmesis and shorter convalescence.