单孔多通道3D腹腔镜肾癌手术的初步应用  

Three dimensional laparoendoscopic single-site radical and partial nephrectomy:an initial clinical experience

作　　者：刘佳毅[1] 王志向[2] 王杰[1] 叶华茂[3] 高轶[1] 李尧[1] 吴震杰[1] 鲍一[1] 刘冰[1] 王林辉[1] LIU Jiayi Wang Zhixiang WANG Jie YE Huamao GAO Yi LI Yao WU Zhenjie BAO Yi LIUBing WANG Linhui(Department of Urology, Changzheng Hospital, Second Military Medical University, Shang- hai, 200003, China Department of Urology, 458th Hospital of PLA aDepartment of Urology, Changhai Hospital., Second Military Medical Universit)

机构地区：[1]第二军医大学长征医院泌尿外科,上海200433 [2]解放军第458医院泌尿外科 [3]第二军医大学长海医院泌尿外科

出　　处：《临床泌尿外科杂志》2016年第11期998-1001,共4页Journal of Clinical Urology

基　　金：上海市领军人才计划项目(编号2013046);长海医院"1255"学科特设提升项目(编号CH125520300);国家自然科学基金面上项目(编号81272817;81172447);上海市自然科学基金项目(编号11ZR1447800)

摘　　要：目的:初步应用单孔多通道3D腹腔镜进行肾癌手术,探讨该手术是否安全可行,评估其优缺点和临床应用前景。方法:我中心从2014年1月起开展单孔多通道3D腹腔镜肾癌手术,至2015年1月共开展肾癌根治术6例,肾部分切除术2例。我们收集了8例患者的基本信息、住院期间各项临床指标及随访资料并进行分析。结果:8例患者手术均顺利完成,并未增加任何辅助切口。本组肾癌根治术和肾部分切除术的手术时间分别为(216.7±51.3)min、(217.5±31.8)min,术中出血分别为(336.7±443.9)ml、(100.0±70.7)ml。其中2例肾部分切除术热缺血时间为16min和24min。术中术后未输血,未出现并发症。患者于术后(2.4±0.5)天恢复胃肠功能,术后住院天数为(5.3±1.4)d。术后平均随访(25.5±3.7)个月,随访期间无肿瘤复发,切口无明显手术瘢痕,体表毁损程度小。结论:单孔多通道3D腹腔镜既具有单孔腹腔镜体表毁损程度小、术后患者疼痛轻、恢复快、切口及Trocar穿刺点相关并发症少等优点,又结合了3D腹腔镜图像立体感强、手术操作精确度高的优势,在一定程度上可以降低单孔腹腔镜缝合、打结等操作的难度,具有良好的临床应用前景。Objective：To report our initial experience of eight patients who underwent 3D laparoendoscopic single-site（LESS）radical and partial nephrectomy.Method：We performed 3D LESS radical and partial nephrectomy on eight patients from January 2014 to January 2015.The perioperative clinical data and follow-up information were collected and analyzed.Result：These eight operations were completed through single-site without any extra skin incision.The operating time for radical and partial nephrectomy were respectively（216.7±51.3）min,（217.5±31.8）min.Estimated blood loss was（336.7±443.9）ml and（100.0±70.7）ml,respectively.There was no perioperative blood transfusion or any other complications.The gastrointestinal function of the patients got recovery on the（2.4±0.5）postoperative day and patients were discharged on the（5.3±1.4）postoperative day.There was no recurrence during postoperative follow-up period of（25.5±3.7）months.All incisions recovered satisfactorily without scar.Conclusions：Three dimensional LESS radical and partial nephrectomy is safe,feasible and effective.Compared with conventional laparoscopic surgery,3D LESS surgery is considered to have better visual effect,less pain,faster recovery and better cosmetic results.Therefore,the 3D technique makes suture and surgical knot much easier to complete through single port,and has good prospects for clinical application.

关 键 词：肾癌根治术 肾部分切除术 腹腔镜术 

分 类 号：R737.11[医药卫生—肿瘤]