相对运动原理在后腹腔镜肾部分切除术中的临床应用及体会  

Relative motion theory in retroperitoneal laparoscopic partial nephrectomy:clinical application and experience

作　　者：彭广[1] 王则宇[1] 张超[1] 过菲[1] 王富博[1] 王辉清[1] 杨波[1] 许传亮[1] 孙颖浩[1] PENG Guang;Wang Ze-yu;Zhang Chao;Guo Fei;Wang Fu-bo;Wang Hui-qing;YanG Bo;Xu Chuan-liang;Sun Ying-hao

机构地区：[1]第二军医大学长海医院泌尿外科,上海200433

出　　处：《第二军医大学学报》2017年第12期1486-1490,共5页Academic Journal of Second Military Medical University

摘　　要：目的探讨利用相对运动原理总结的5大技巧降低后腹腔镜肾部分切除术中缝合关闭肾脏创面难度的可行性和优势。方法回顾性分析第二军医大学长海医院2014年1月至2016年5月间收治的89例行后腹腔镜肾部分切除术患者的临床资料,其中对照组42例、技巧组47例。技巧组术中严格运用"1动、2加、3推、4拉、5换"5大技巧缝合关闭肾脏创面,对照组未完全运用这5大技巧。观察比较两组肾脏热缺血时间、手术时间、术中出血量、肾功能及围手术期并发症。结果 89例手术均顺利完成。技巧组平均热缺血时间(22.4±4.9)min,手术时间(96.0±11.6)min;对照组平均热缺血时间(24.5±4.8)min,手术时间(102.0±13.7)min,两组差异均有统计学意义(P<0.05)。两组患者术中出血、输血及血管损伤情况差异均无统计学意义,均无术后出血、漏尿等并发症。结论利用相对运动原理总结的5大技巧安全有效,具有良好的临床可行性,可缩短手术时间及肾脏热缺血时间。ObjectiveTo investigate the feasibility and advantages of five skills summarized by relative motion theory in reducing difficulty of suturing the kidney during retroperitoneal laparoscopic partial nephrectomy.MethodsWe retrospectively analyzed the clinical data of89patients undergoing retroperitoneal laparoscopic partial nephrectomy in the Department of Urology of Changhai Hospital,Second Military Medical University between Jan.2014and May2016.There were42cases in the control group and47cases in the skill group.Five skills including“move,add,push,pull,and shift”were strictly applied to reconstruct the kidney in the skill group,but not fully used in the control group.Warm ischemic time,operation time,intra operative blood loss,renal function and complications were compared between the two groups during and after operation.ResultsThe operations were successfully completed in all the89cases.The average warm ischemic time was(22.4±4.9)min and the operation time was(96.0±11.6)min in the skill group;while those in the control group were(24.5±4.8)min and(102.0±13.7)min,respectively,and the differences between the two groups were statistically significant(P<0.05).There were no significant differences in the intra operative blood loss,blood transfusion or artery injury between the two groups.No complications such as urine leakage or post operative bleeding were observed in either groups.ConclusionThe five skills summarized by relative motion theory are clinically feasible and safe in retroperitoneal laparoscopic partial nephrectomy,and can shorten operation time and renal warm ischemic time.

关 键 词：肾肿瘤 肾部分切除术 腹腔镜肾切除术 相对运动 

分 类 号：R699.2[医药卫生—泌尿科学] R737.11[医药卫生—外科学]