后腹腔镜重复肾上位半肾切除术疗效观察  

Clinical observation on therapeutic efficacy of retroperitoneoscopic upper-pole heminephrectomy for duplex kidneys

作　　者：葛建章[1] 陈湘[1] 

机构地区：[1]中南大学湘雅医院泌尿外科,湖南长沙410008

出　　处：《中国内镜杂志》2010年第10期1020-1023,共4页China Journal of Endoscopy

摘　　要：目的回顾性比较后腹腔镜重复肾上位半肾切除术与开放重复肾上位半肾切除术的临床疗效,探讨后腹腔镜重复肾上位半肾切除术的临床应用价值。方法回顾性分析后腹腔镜上位半肾切除术患者30例(后腹腔镜组)及开放上位半肾切除术32例(开放组)术中、术后及随访指标,对其结果进行统计学分析。结果两组比较在手术时间、主要并发症及次要并发症发生率方面无显著性差异(P>0.05);两组在手术切口长度、术中估计失血量、术后肛门排气时间、术后静脉应用抗生素时间、术后止痛药应用例数、术后体温恢复正常时间、术后留置引流管时间、术后下床活动时间、术后住院时间方面有显著性差异(P<0.05)。腹腔镜组早期手术时间长于开放手术组,后期短于开放手术组;腹腔镜组手术时间随手术例数的增加有一定的下降趋势。结论与传统开放手术相比,后腹腔镜下重复肾上位半肾切除术能达到开放手术的临床疗效,且具有创伤小、术后恢复快的优势;后腹腔镜重复肾上位半肾切除术虽然手术操作难度大,但随着术者操作经验的积累,手术时间逐渐缩短。【Objective】To evaluate the clinical value on retropritoneoscopic upper-pole heminephrectomy for duplex kidneys. 【Methods】Clinical data of 30 paients of duplex kidney with nonfunctioning upper-pole moiedties who underwent retoperitoneoscopic upper-pole heminephrectomy were retrospectively compared with those of 32 patients who underwent open upper-pole heminephrectomy, including the intraoperative, postoperative and follow-up information.【Results】There were no significant differences between the 2 groups in terms of the duration of operation, the rate of main and second complication （P 0.05）; there were significant differences between the 2 groups in terms of length of incision, intraoperative estimated blood loss, time to anal exsufflation, time of postoperative intravenous antibiotic,cases of postoperation analgesia, temperature recovery time, time of postoperative drainage, time to ambulation, postoperative hospital stay （P 0.05）; We observed a slight tendency for the duration of the procedure to decrease with experience. 【Conclusions】In comparision of traditional open heminephrectomy, retoperitoneoscopic upper-pole heminephrectomy is safe and effective technique with minimal invasion and quicker postoperative recovery, and there is a slight tendency for the duration of the laparoscopic procedure to decrease with experience.

关 键 词：重复肾 后腹腔镜 上位半肾切除术 

分 类 号：R692.1[医药卫生—泌尿科学]