内镜辅助下小切口术式在泌尿外科中的应用

目的：评价内镜辅助下小切口术式的临床应用效果。方法：对42例患者行内镜辅助下小切口手术，其中根治性肾切除2例。单纯性肾切除3例（结核肾，无功能肾），盂管成形术3例，肾盂输尿管切开取石术2例，肾囊肿去顶减压术17例，肾上腺肿瘤切除15例。18例肾上腺肿瘤行腹腔镜手术。结果：根治性肾切除或单纯性肾切除手术时间平均120min，术中出血量约100ml；盂管成形术、肾盂或输尿管切开取石术。术中出血量约50-80ml；肾囊肿去顶减压术手术时间平均30-60min，肾上腺肿瘤切除手术时间平均110min，术中出血量约50-80ml。内镜辅助下小切口泌尿外科手术术中出血量、术后住院时间、手术切口长度与腹腔镜组比较差异无统计学意义；在手术时间和住院费用方面则优于腹腔镜组，差异有统计学意义。结论：内镜辅助下小切口泌尿外科手术具有创伤小、价格低、无需专门设备及人员培训的特点，易于推广普及，为泌尿外科微创手术提供了新方式。

Endoscopy applicated mini-incision surgery in urology

Objective: To evaluate the clinical experience and the value of portless endoscopic surgery in urology. Methods: Forty-two cases in witch renal cell carcinoma (2 cases), renal tuburcuolosis and no function kidney (3 cases), uretero-pelvic junction obstruction (3 cases), urinary stone disease (2 cases), renal cyst (17 cases), 15 of 33 adrenal tumors, were received portless endoscopic surgery, and the remain 18 cases were received laparoscopic adrenalectomy. Results:The average operation time was 120 min for radical nephrectomy, and 110 min for adrenalectomy, 60-90 min for pyeloplasty and pyelolithotorny, 30 -60min for surgical decompression of renal cyst. Comparing Portless endoscopic and laparoscopic adrenalectomy in blood loss, post operative hospital stay, and the length of the incision there was no significant difference between them, in operating time, and cost of hospitalization the Portless endoscopic adrenalectomy was superior than laparoscopic one. Conclusion:The Portless endoscopic surgery in urology has the advantages of micro-invasive, lower cost of hospitalization, no request for special facilities and special training, is easy to popularize.