后腹腔镜手术治疗肾上腺和肾脏疾病(附68例报道)  

Extraperitoneal Laparoscopic Management of Renal and Adrenal Disease: Primary Clinical Exprience with 68 Cases

作　　者：朱从太 曹庆伟 

机构地区：[1]山东省莱钢集团公司医院泌尿外科,山东莱芜271126 [2]山东省省立医院泌尿外科,山东济南271126

出　　处：《中国医药指南》2011年第12期36-37,共2页Guide of China Medicine

摘　　要：目的探讨后腹腔镜手术治疗泌尿外科肾上腺和肾脏疾病适应证的选择和治疗效果。方法回顾分析2003年11月至2010年3月68例后腹腔镜肾脏、肾上腺手术,其中肾上腺手术32例,原发性醛固酮增多症20例,嗜铬细胞瘤1例,肾上腺皮质增生6例,无功能腺瘤5例。肾切除术2例,肾动脉狭窄1例,肾积水2例。肾囊肿去顶减压术31例,其中多发囊肿12例,双侧囊肿2例,单发囊肿17例。结果 68例后腹腔镜手术均获成功。所有切除标本均经病理证实。肾上腺手术和肾切除术出血50~100mL,肾囊肿去顶减压术出血少于50mL,无术中输血。发生并发症4例,其中皮下气肿2例,腹膜损伤2例,均无需特殊处理。术后住院时间3~8d。结论后腹腔镜手术治疗泌尿外科肾上腺和肾脏疾病具有切口小、出血少、恢复快、住院时间短等优点。Objective To discuss the primary clinical experience and the effect of extraperitoneal laparoscopic management of urologic disease.MethodsFrom november 2003 to march 2010,68 retroperitoneal laparoscopic surgeries for either renal or adrenal disease were performed in laiwu steel group hospital of shandong.There are 32 cases of adrenal tumors,including primary hyperaldosteronism（20）,pheochromocytoma（1）,adrenal cortical hyperplasia（6）,and non-functioning adenoma（5）.The other 36 cases included nephrectomy（2）,renal arterial stenosis（1）,hydronephrosis（2）,and cyst decortication（31）.Among the surgery of laparoscopic cyst decortication,there were 12 patients with polycysts,2 with bilateral renal cysts,and 17 with single renal cysts.ResultsThe operations were performed within the retroperitoneal space.All diagnosis was confirmed by postoperative pathology.The bleeding volume were 50-100mL in retroperitoneal laparoscopic adrenalectomy/tumor enucleation or nephrectomy,less than 50mL in marsupialization of the renal cyst.No patient need blood transfusion.4 cases of complications were reported.Most of the complications need not management.The postoperative hospitalization was 3-8 days.ConclusionsExtraperitoneal laparoscopic management of urologic disease has the advantage of minimal irvasion,less blood loss,quicker recovery and shorter hospitalization.

关 键 词：泌尿外科 腹腔镜 手术 

分 类 号：R69[医药卫生—泌尿科学]