经腹腹腔镜肾切除术治疗成人巨大肾积水26例报告  

Transperitoneal laparoscopic nephrectomy for adult giant hydronephrosis:a report of 26 cases

作　　者：孙建涛[1] 毛克敬 杨金辉[1] 郝彤彤[1] 霍庆祥[1] 

机构地区：[1]郑州大学附属洛阳中心医院,河南洛阳471002

出　　处：《腹腔镜外科杂志》2016年第3期220-222,共3页Journal of Laparoscopic Surgery

摘　　要：目的：探讨经腹腹腔镜肾切除术治疗成人巨大肾积水的临床疗效、安全性及手术技巧。方法：回顾分析2012年5月至2015年7月采用经腹入路为26例巨大肾积水患者行腹腔镜肾切除术的临床资料,其中男17例,女9例;19~61岁,平均（42.0±6.7）岁。肾盂输尿管交界处狭窄13例,输尿管结石10例,输尿管膀胱连接部梗阻3例。左侧15例,右侧11例。通过改进手术方法,观察手术时间、术中出血量、术后住院时间、并发症及手术效果。结果：26例手术均获成功,无中转开放手术及严重并发症发生。肾积水量平均（4 800±1 860）ml,手术时间平均（76±19）min,术中出血量平均（55±27）ml,术后平均住院（6.4±1.3）d。结论：成人巨大肾积水行腹腔镜肾切除术是安全、可行的,通过一定的技巧改进有助于手术的顺利进行,值得推广。Objective： To evaluate the clinical effect,safety and skill of transperitoneal laparoscopic nephrectomy for adult giant hydronephrosis. Methods： Clinical data of 26 patients（ 17 males and 9 females） who underwent transperitoneal laparoscopic nephrectomy for giant hydronephrosis were analyzed retrospectively between May 2012 and Jul. 2015. The mean age was（ 42. 0 ± 6. 7） years（ range,19-61 years）. The pathogenesis of giant hydronephrosis was various,including 13 cases of ureteropelvic junction stricture,10 cases of ureteral stones,and 3 cases of ureterovesical junction obstruction,15 cases in the left side and 11 cases in right side. The operative time,estimated blood loss,postoperative hospital stay,complications and the efficiency were recorded by improvement of surgical techniques. Results： All operations were performed successfully without conversion to open surgery or serious complications. The average volume of hydronephrosis was（ 4 800 ± 1 860） ml. The mean operative time was（ 76 ± 19） min,and estimated blood loss was（ 55 ±27） ml. The mean postoperative hospital stay was（ 6. 4 ± 1. 3） d. Conclusions： The transperitoneal laparoscopic nephrectomy is technically feasible and safe for adult giant hydronephrosis. Some skill improvement may be contributed to the successful operation,and deserves to be recommended in the clinical application.

关 键 词：肾盂积水 巨大 肾切除术 腹腔镜检查 经腹 

分 类 号：R699.2[医药卫生—泌尿科学]