3D腹腔镜在泌尿外科手术中的应用体会  

The application experience of 3D laparoscopic operation in the urology

作　　者：罗超[1] 李化升 

机构地区：[1]玉林市红十字会医院,广西玉林537000

出　　处：《国际泌尿系统杂志》2016年第4期580-584,共5页International Journal of Urology and Nephrology

基　　金：广西壮族自治区卫生厅自筹经费科研课题（Z2014529）

摘　　要：目的探讨3D腹腔镜在泌尿外科手术中的应用价值。方法应用Storz3D腹腔镜完成泌尿外科手术48例，参照经典的手术方式在三维立体手术视野下完成手术。统计手术时间、术中出血量、术后引流量、并发症、术后住院天数等。结果本组除1例中转开放性手术外，其余均在3D腹腔镜下顺利完成手术。后者手术时间29—365min，其中经腹后腔肾上腺肿瘤切除术、根治性肾切除术（5例）、单纯性肾切除术、包膜下肾切除术、肾和输尿管全程切除术、肾囊肿去顶减压术、肾部分切除术、肾盂输尿管成形术时间分别为29～150min、46—175min、60～105min、96～145min、135～150min、35—50min、125min、105—120min；经腹腔肾上腺肿瘤切除术（1例）、根治性肾切除术（3例）、输尿管狭窄闭锁段切除吻合术、输尿管粘连松解术、输尿管切开取石术、双侧输尿管膀胱再植术、根治性膀胱切除＋回肠膀胱术（双侧髂血管旁淋巴结清除＋膀胱切除时间）、膀胱壁修补术时间分别为175min、148—164min、90～140min、45min、45～55min、185min、246—268min、30～48min。肾蒂阻断时间、肾盂输尿管成形吻合时间、输尿管端端吻合时间、输尿管缝合时间、双侧输尿管膀胱吻合时间分别为22min、90～105min、40—44min、10～35min、82min。术中出血量10～450mL，术后引流量100—500mL，术后继发出血2例，术后住院5～21d，无一例因手术死亡。结论3D腹腔镜适用于泌尿外科各种手术，特别是高难度手术更有优势，提供了真实的三维立体术野，有较好的应用价值。Objectives To explore the application value of 3D （high definition, HD） laparoscopic operation in the urology. Methods 48 cases of operations were completed with the help of Storz 3D HD laparoscopic. Referred to the classic operaions, all the surgeons successfully completed surgery.The operation time, amount of bleedingj postoperative volume of drainage, complications and hospital stays were evaluated. Results The operations were successfully completed with the help of 3D HD laparoscopic except that 1 case was converted to open operation. The operation time was 29 - 365 min. 5 cases were the abdominal cavity after resection of adrenal tumor and radical nephrectomy. The time of simple nephrectomy,subcapsular nephrectomy, renal and ureter full nephrectomy, renal cystdecortication, partial nephrectomy, laparoscopic pyeloplasty was 29 - 150min,46 - 175min,60 - 105min,96 - 145min, 135 - 150min,35 - 50min, 125min, 105 - 120min respectively. The time of transperitoneal adrenal tumor resection （1 case）, radical nephrectomy （3 cases）, ureteral stricture or atresia ureter resection and anastomosis, lysis of adhesions, ureterolithotomy, bilateral ureteral reimplantation, after radical cystectomy and ileal neobladder （bilateral iliac blood vessels lymphadenectomy bladder resection time） and the bladder wall repairing was 175min, 148 - 164min, 90 - 140min, 45min, 45 - 55min, 185min,246 - 268min,30 - 48min respectively. The time ofrenal pedicle occlusion, anderson hynes anastomosis, end- to -end ureteral anastomosis, ureter suture and bilateral ureter bladder anastomosis was 29min,90 - 105min,40-44min,10- 35min,82min respectively. The blood loss and postoerative volume of drainage was 10 -450mL, 100 - 500mL. 2 cases were the postoperative bleeding, and postoperative hospital stays were 5 - 21d. There was no operative death in the group. Conclusions 3D HD laparoscopic operation is suitable for all kinds of operations in the urology, especially for delicate operations. It provides true three - dimensional operati

关 键 词：泌尿外科手术 腹腔镜 

分 类 号：R699[医药卫生—泌尿科学]