自制单孔后腹腔镜低温肾部分切除术的初步经验总结(附4例报告)  

Retroperitoneal laparoscopic ice cubes renal hypothermia for partial nephrectomy using home-made single-port device:the initial experience of 4 cases report

作　　者：祖强[1] 史立新[1] 蔡伟[1] 张旭[1] 董隽[1] 

机构地区：[1]中国人民解放军总医院泌尿外科,北京100853

出　　处：《微创泌尿外科杂志》2013年第2期97-99,共3页Journal of Minimally Invasive Urology

摘　　要：目的:建立利用自制单孔设备进行后腹腔镜下低温环境肾部分切除的手术方式,并评估安全性和可行性.方法:2011年6月～2011年9月采用自制单孔多通道设备,使用常规腹腔镜操作器械先后完成4例经后腹腔低温环境下的肾部分切除手术.结果:患肾均为右侧,平均手术时间126.5 min,术中出血量15～60 ml,肾平均缺血时间24.5 min.患者均顺利完成手术无中转开放,手术前后肾功能变化不大,均正常范围,1周左右出院,无手术并发症,术后病理均为肾透明细胞癌(T1a).结论:采用自制单孔多通道设备完成后腹腔镜低温环境下肾部分切除术技术可行,安全可靠,费用低；与常规腹腔镜手术相比,复杂性增加,但却可能延长肾缺血时间,保护残肾功能,是一种有应用前景的手术方式.Objective:To investigate the feasibility and safety of a novel technique of retroperitoneal laparoscopic single-site(LESS) renal hypothermia with intracorporeal ice cubes during partial nephrectomy using home-made single-port device.Methods:Between June 2011 and September 2011,4 consecutive LESS right partial nephrectomies using home-made single-port device with renal hypothermia were performed through retroperitoneal access in our center.Results:The procedures were completed and no complication occured in all patients.Mean operative time was 126.5 min.Estimated blood loss was 15-60 ml.Average ischemia time was 24.5 min.Postoperatively renal function have no significant change in all cases.Hospital stay was about 6.8 days after operation.Histopathology confirmed renal cell carcinoma(T_(1a) Stage) in them.Conclusions:LESS ice cubes renal hypothermia for partial nephrectomy using home-made single-port device in our initial experience is feasible and safe.It is also cost-saver and little complicated with conventional laparoscopic partial nephrectomy.Compared with conventional laparoscopic operation,this technique adds to its complexity,but it maybe prolongs the tolerable ischemia time of the kidney and protect the remnant renal function.

关 键 词：低温 自制单孔腹腔镜手术 肾部分切除术 

分 类 号：R737.11[医药卫生—肿瘤]