改良Foley切口——后腹腔镜上尿路手术大标本取出的创新入路  

Modified Foley incision—an innovative approach for intact specimen extraction during retroperitoneal laparoscopic upper urinary tract surgery

作　　者：程庆[1] 禹刚 王国任 李东辉[1] 王锐锋 白志明[1] CHENG Qing;YU Gang;WANG Guo-ren;LI Dong-hui;WANG Rui-feng;BAI Zhi-ming(Department of Urology,Central South University Xiangya School of Medicine Affiliated Haikou Hospital,Haikou 570208,China)

机构地区：[1]中南大学湘雅医学院附属海口医院泌尿外科,海南海口570208

出　　处：《现代泌尿外科杂志》2020年第10期876-879,共4页Journal of Modern Urology

基　　金：海南省重点科技计划(社会发展)(No.ZDYF2016137)。

摘　　要：目的介绍一种用于后腹腔镜上尿路手术大标本取出的创新入路、手术方法,并分享手术经验。方法2016年8月至2017年9月,由同一术者行后腹腔镜上尿路手术大标本取出17例,标本装袋后采用改良Foley切口将其取出,记录手术及术后恢复等相关指标。结果17例患者标本均顺利取出,平均取出时间31.2(21~37)min,每个标本平均最小两径之和为12.3(8.6~19.3)cm。采用疼痛数字评分法(NRS)评估术后24 h静息疼痛为1~4分(中位评分2分),24 h下地活动疼痛评分1~7分(中位评分4分),无患者需要使用止痛药。术后住院时间3~15 d(中位时间5 d)。经过最长12(平均7.1)个月的随访,3例出现肋下神经支配区域的麻木,未出现切口疝。结论改良Foley切口是后腹腔镜手术大标本取出的有效方式,初期效果满意。Objective To introduce a modified Foley incision for intact specimen extraction during retroperitoneal laparoscopic surgery and to share the surgical experience.Methods During Aug.2016 and Sep.2017,17 pathological specimens of the upper urinary tract were removed from different patients in retroperitoneal laparoscopic surgery by the same surgeon.All specimens were taken through the modified Foley incision.The clinical data were recorded.Results All specimens were extracted successfully.The extraction time was 31.2(21-37)min.The sum of two minimum-diameter was 12.3(8.6-19.3)cm.The NRS score of resting pain 24 h after operation was 1-4 points(median 2 points),and the score of motion pain was 1-7 points(median 4 points).No patients needed analgesic use.The postoperative hospital stay was 3-15(median 5)days.During the follow-up of 3-12(average 7.1)months,paresthesia in the subcostal innervation area was observed in 3 cases.No patients developed incisional hernia.Conclusion The modified Foley incision is an effective way for large specimen extraction during retroperitoneal laparoscopic surgery,and the initial results are satisfactory.

关 键 词：后腹腔镜 肾脏疾病 标本取出 切口 改良方式 

分 类 号：R615[医药卫生—外科学]