后腹腔镜肾癌根治术的技术改进及临床效果(附30例报告)

目的 :评价后腹腔镜肾癌根治性切除术 (肾癌根治术 )改进后的临床效果。方法 :回顾性分析和比较30例后腹腔镜肾癌根治术的临床资料 ,比较其术中出血量、手术时间及术后恢复情况。结果 :后腹腔镜肾癌根治术经过技术改进 ,手术时间缩短 ,术中出血量明显减少 ,平均手术时间 10 1± 4 1.4min(由最初 5例平均 16 6min减少到最后 5例平均 74min) ,术中平均出血量 5 1± 4 4ml(由最初 5例平均 10 4ml减少到最后 5例平均 2 6ml) ,术后肠功能恢复时间平均 32± 18h ,术后下床活动时间 30 .4± 12h ,术后住院天数 5 .6± 1.5d ,术中及术后未发生明显并发症 ,随访 2～ 2 0个月未见肿瘤复发及穿刺通道的种植性转移。结论 :与传统的腹腔镜根治性肾癌切除术相比 ,改进后的后腹腔镜肾癌根治术具有手术时间短、出血少、并发症少等优点

Modified techniques and clinical results of retroperitoneal laparoscopic radical nephrectomy

Purpose: To evaluate the clinical results of modified techniques of classical retroperitoneal laparoscopic radical nephrectomy. Methods:We reviewed 30 patients with renal neoplasm receiving radical nephrectomy via the retroperitoneal laparoscopic approach from April, 2000 through March, 2002, retrospectively. Operation time, amount of bleeding during operation were compared, and all the cases are under watchful follow up. Results: After we modified some techniques of retroperitoneal laparoscopic radical nephrectomy, the operation time and blood loss decreased considerably, and no marked complications occurred preoperatively, we haven't found any local relapse and tumor seeding of the port sites during follow up.Conclusions: Compared with classical retroperitoneal laparoscopic radical nephrectomy, modified techniques can decrease operation time and blood loss effectively, and can decrease the rate of complication remarkably.