单孔腹腔镜技术在腹膜透析置管术的应用研究  

Clinical investigation of one-port laparoscopic placement of peritoneal dialysis catheters

作　　者：燕翔[1] 朱微[1] 蒋春明[1] 黄海峰[1] 王玉忠[1] 张苗[1] 郭宏骞[1] 

机构地区：[1]南京大学医学院附属鼓楼医院泌尿外科(卫生部内镜诊疗技术培训基地),江苏南京210008

出　　处：《中国内镜杂志》2010年第8期873-875,共3页China Journal of Endoscopy

摘　　要：目的研究单孔腹腔镜技术用于腹膜透析置管术的可行性、安全性和疗效。方法 18例术前均无腹腔手术史的慢性肾衰竭患者,局部麻醉下采用经皮微创穿刺技术建立下腹部16Fr腹腔通道,使用直径5mm腹腔镜进入腹腔内定位,通过一次性可剥鞘将Swan-neck腹膜透析管一端放置到膀胱直肠窝或子宫直肠窝,近端建立皮下隧道并经左下腹戳洞引出。结果所有腹膜透析管均放置成功,平均手术时间26.5min(14～35min),术中出血极少,术后2～4d出院。平均随访10.6个月(6～18月),未见漂管、渗漏、堵管、出血及感染等并发症。结论单孔腹腔镜技术是一种安全可行、定位精确的腹膜透析置管新方法。【Objective】To investigate the clinical feasibility,safety and effect of one-port laparoscopic placement of peritoneal dialysis catheters. 【Methods】18 consecutive chronic renal failure patients underwent laparo-scopic placement of Swan-neck catheters. All patients were eligible to receive local infiltration anesthesia and none had had a previous peritoneal catheter placed. Videoscopic monitoring was performed via a peer-away sheath through an incision near the umbilicus,a 16Fr peer-away sheath was then inserted toward the bladder and rectum. The Swan-neck catheter was passed through the peer-away sheath into the the true pelvis. A subcutaneous tunnel was created and a point in left lower quadrant was selected as the exit site of the catheter. 【Results】All the catheters were successfully placed and the mean time of operation was 26.5 minutes （14 to 35 minutes）. The patients were discharged 2～4 days following the operation. During mean follow-up period of 10.6 months （6 to 18 months）,there was no catheter-related complications,such as catheter migration,dialysate leakage,exit-site infection and bacterial peritonitis. 【Conclusions】One-port laparoscopic technique is a simple,safe and effective method for placement of peritoneal dialysis catheters.

关 键 词：腹腔镜 腹膜透析管 

分 类 号：R692.5[医药卫生—泌尿科学]