后腹腔镜肾癌根治术64例报告  

Retroperitoneal laparoscopic radical nephrectomy with a report of 64 cases

作　　者：程晓冬[1] 施卫国[1] 丛军[1] 杨春[1] 徐新宇[1] 

机构地区：[1]江苏省无锡市第二人民医院泌尿外科,江苏无锡214002

出　　处：《中国内镜杂志》2009年第8期870-871,874,共3页China Journal of Endoscopy

摘　　要：目的探讨后腹腔镜肾癌根治术的技术要点和临床效果。方法2004年1月～2007年12月采用后腹腔镜技术行肾癌根治术64例,术前均行B超、IVU、胸片、CT或MRI检查,证实肾脏实质恶性肿瘤,未发现肾蒂淋巴结转移、远处转移、肾静脉或腔静脉癌栓。临床分期为T1～T3aN0M0,健侧肾功能正常。观察手术时间、术中出血量、术中术后并发症及手术效果。结果手术均1次成功,手术时间60～180min,平均90min,术中出血80～240mL,术中术后均未输血,引流管拔除时间24～72h,肠功能恢复时间18～48h,下床活动时间48～72h。64例患者中52例获得随访3～36个月,无肿瘤复发及切口种植转移。结论后腹腔镜肾癌根治术具有创伤小、恢复快、疗效可靠的特点,可部分替代传统的开放手术,具有良好的临床应用前景。[ Objective ] To discuss the technical detail of retroperitoneal lapamscopic radical nephrectomy and evaluate its clinical effect. [Methods ] Totally 64 cases received retroperitoneal laparoscopie radical nephrectomy between January 2004 and December 2007. Malignant tumors were confirmed by B-ultrasound, IVU, X-ray, and CT or MRI before operation in all the eases. None of renal pediele lymphatic metastasis, distant metastasis, renal venous or inferior vena cava tumor thrombus was found, and renal function of the uninfected kidney was within the normal range. Renal neoplasms were all in T1-T3aN0M0. The operative time, intraoperative blood loss, perioperative complications and operative effect were evaluated. [ Results ] All the operations were successful and effective. The operating time was 60-180 minutes with an average of 90 minutes. The blood loss volume was 80-240 mL. The extubation time was 24-72 hours. The time for postoperative recovery of intestinal function was 18-48 hours. Postoperative ambulation time was 48-72 hours. None of the patients received blood transfusion or had obvious complication. After a follow-up of 3-36 months in 52 of the 64 renal neoplasm cases, neither local relapse nor tumor seeding at the incision site was found. [ Conclusions ] Retroperitoneal laparoseopic radical nephrectomy is proved to be an effective procedure with minimal invasion and quicker recovery. It can partly take place of conventional open surgery, and will have a good prospect in the clinical urological practice.

关 键 词：肾肿瘤 腹腔镜 肾切除 经腹膜后 

分 类 号：R737.11[医药卫生—肿瘤]