背下方入路肾蒂处理技术在经腹腔途径腹腔镜根治性肾切除术中的临床应用  

Inferoposterior access to the renal pedicle during laparoscopic radical nephrectomy by laparoscopy approach

作　　者：程小宝 罗光彦 卢振权 熊林 姜奕 袁渊 Cheng Xiaobao;Luo Guangyan;Lu Zhenquan(Department of Urology Surgery,the University of Hong Kong-Shenzhen Hospital,Shenzhen 518053)

机构地区：[1]香港大学深圳医院泌尿外科,广东深圳518053

出　　处：《中国现代医药杂志》2020年第10期25-28,共4页Modern Medicine Journal of China

摘　　要：目的探讨经背下方入路肾蒂处理技术在经腹腔途径腹腔镜根治性肾切除术中的安全性和有效性。方法回顾性分析2014年6月~2019年6月在我院接受单一术式完成经腹腔途径根治性肾切除术的79例患者临床资料,其中经背下方入路肾蒂处理组38例(实验组),经前方入路肾蒂处理组41例(对照组),记录两组患者的基线资料、术中解剖表现以及肾蒂处理时间、术后结果等资料。结果两组患者的平均年龄、体质指数、肿瘤大小、肾血管数目和术后住院时间相比均无统计学差异(P>0.05)。实验组平均手术时间较对照组短[(133.24±29.70)min vs(153.46±39.94)min,P<0.05],实验组平均肾血管处理时间较对照组短[(46.42±6.65)min vs(64.46±7.64)min,P<0.05]。实验组平均出血量比对照组少[(46.05±17.64)ml vs(66.34±57.78)ml,P<0.05]。两组均无中转开放手术病例。结论在经腹腔途径腹腔镜根治性肾切除术中,应用背下方入路的肾蒂处理技术改善了肾蒂血管显露,缩短了手术时间而且增加了手术安全性。Objective To assess the safety and efficacy of laparoscopic radical nephrectomy by laparoscopy approach(TLRN)via the inferoposterior access to the renal pedicle.Methods A retrospective review of 79 patients underwent TLRN by single operation from Jun 2014 to Jun 2019 in our hospital was carried out.Access of the renal pedicle was via the inferoposterior approach in 38 cases(study group),and 41 cases were via the conventional anterior approach(control group).Baseline information,intra-operative anatomical findings operative time on renal pedicles and post-operative outcomes were recorded.Results No significant differences were found in mean age,body mass index,tumor size,number of renal vasculature identified,and post-operative length of stay between the two groups.The study group had shorter operative time[(132.24±29.70)min vs(153.46±39.94)min,P<0.05],shorter mean renal vascular treatment time[(46.42±6.65)min vs(64.46±7.64)min,P<0.05].Less average blood loss was also observed in the study group[(46.05±17.64)ml vs(66.34±57.78)ml,P<0.05].Overall,none of the patients required conversion to open.Conclusion The inferoposterior access to the renal pedicle can improve exposured of renal pedicle vascular,shorten operation time and increase surgical sefety in laparoscopic radical nephrectomy by laparoscopy approach.

关 键 词：腹腔镜 背下方入路 肾蒂 根治性肾切除术 

分 类 号：R699.2[医药卫生—泌尿科学]