腹腔镜下经后腹膜切除结核性无功能肾的应用价值

 目的 探讨后腹腔镜手术切除结核性无功能肾的应用价值。方法 收集西藏军区总医院37例后腹腔镜切除结核性无功能肾的临床资料。统计手术时间、术中出血量、术后住院时间、术后并发症、病人随访情况等指标,综合评价该手术方法的有效性及安全性。结果 37例均成功实现腹膜后腹腔镜下切除,手术时间120~200 min,平均(150±23)min;术中出血80~300 ml,平均(l50±36)ml。所有切口均一期愈合,术后住院时间5~7 d,平均(6±1)d。随访6～24个月,平均(12±3)个月,无远期并发症。结论 腹腔镜下经后腹膜切除结核性无功能肾安全、有效、可靠。

Clinical value of retroperitoneal laparoscopic nephrectomy for tuberculous nonfunctioning kidney

Objective To investigate the clinical value of retroperitoneal laparoscopic nephrectomy for patients with tuberculous nonfunctioning kidney. Methods Reports of 37 patients undergoing retroperitoneal laparoscopic nephrectomy for tuberculous nonfunctioning kidney were reviewed. We analyed the surgical operation duration, blood loss, duration of hospital stay after surgery, complications after surgery and patient follow-up, and evaluated the efficiency and safety of the surgery. During the operation, we dissected the kidney and ureter with PK and then blocked the kidney pedicle with a hemostat. The kidney was removed with a renal bag, then it was pulled out through an oblique incision made at the lower abdomen. Antituberculosis therapy was carried out both before and after the surgery. Results Retroperitoneal laparoscopic nephrectomy was successfully completed in all of the 37 patients. The operation duration ranged from 120 to 200 minutes with a mean of 150 minutes; during the operation, the mean blood loss was 150 ml (ranging, 80-300 ml); all the patients showed primary healing of the wound; after the surgery, the patients were discharged from the hospital in 5 to 7 days (mean, 6 days). A mean of 12-month follow-up (ranging from 6 to 24 months) was achieved in all the patients. There was no long-term complication. Conclusions Retroperitoneal laparoscopic nephrectomy is a safe and effective procedure for tuberculous nonfunctioning kidneys.