后腹腔镜肾癌根治术手术入路与肾周解剖特点研究（附82例报告）

目的：研究肾周腹膜后腔的解剖特点，探讨经后腹腔镜进行肾癌根治性切除术的手术入路。方法：采用后腹腔镜技术对82名肾癌患者行肾癌根治性切除术，通过术中观察、手术录像及总结既往经验，分析肾周解剖结构的特点、相互关系，以寻找更加安全、可靠、快捷的手术路径。结果：82例手术顺利，手术平均时间120．32min，平均出血量70．32ml，术中及术后未出现严重并发症，48例获7～77个月随访，1例术后34个月局部复发，术后4年死于转移性。肾癌。结论：利用肾周腹膜后腔的解剖特点，合理选择手术入路，可以减少出血，缩短手术时间，并且减少术后并发症的发生，提高疗效。

Anatomical Features Study of Retroperitoneal Cavity Around Kidney and Retroperitoneoscopic Operative Approach for Radical Nephrectomy

Objective：To study the operative approach for retroperitoneoscopic radical nephrectomy of renal cell carcinoma and anatomical features of retroperitoneal cavity around kidney. Methods.. Retroperitoneoscopic radical nephrectomies were performed on 82 patients. Through the videos and photographs of these operations, the expe riences were summarized and the anatomical features were analyzed to seek safer, more effective operative skills. Results：82 operations were successful. The mean operation time was 120. 32 min, the mean intraoperative blood loss was 70 . 22 ml. There was no severe complications during surgery and after surgery. Follow-up was carried out for 7-77 months in the 48 patients. 1 case was founded local recurrence in 34 months after surgery, and died after 4 years of metastatic renal cell carcinoma. Conclusions： Choosing proper operative approach through understanding the anatomical features of retroperitoneal cavity around kidney, can save the operation time, with less bleeding and less complications and enhance the effectiveness of operation.