后腹膜返折韧带在后腹腔镜肾上腺切除术中的定位价值  

The value of superior retroperitoneal fold ligament for location in retroperitoneal laparoscopic adrenalectomy

作　　者：苏容万 张玉涛 邓天星 冯泽恩 于鹏 时圣力 张家伟 Su Rongwan;Zhang Yutao;Deng Tianxing;Feng Ze’en;Yu Peng;Shi Shengli;Zhang Jiawei(Department of Urology,970 Hospital of the PLA,Shandong 264002,China)

机构地区：[1]解放军第九七〇医院泌尿外科,山东264002

出　　处：《中华腔镜泌尿外科杂志（电子版）》2021年第1期17-19,共3页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的探讨以后腹膜返折韧带为解剖标志在后腹腔镜肾上腺切除术中准确定位肾上腺的临床可行性及意义。方法回顾性分析我院2016年3月至2019年11月期间40例行后腹腔镜肾上腺切除术患者的临床资料,男22例,女18例,平均年龄54岁,肿瘤最大径1.2~5.6 cm,平均3.4 cm。以后腹膜返折韧带为解剖标志,设计手术第一步制作肾周筋膜切口的顶端标记点,沿此垂直身体纵轴向深面分离直达肾上腺完成准确定位。结果本组40例均准确定位肾上腺后完成手术。平均手术时间45 min,平均术中出血量20 ml,平均下床活动时间12 h,平均术后住院天数4 d。结论在后腹腔镜肾上腺切除术中,以后腹膜返折韧带为解剖标志,制作肾周筋膜切口的顶端标记点,可准确定位肾上腺,值得在临床推广使用。Objective To investigate the clinical feasibility and value of using superior retroperitoneal fold ligament as an anatomic landmark to accurately locate adrenal in retroperitoneal laparoscopic adrenalectomy.Methods The clinical data of 40 patients(male:22,female:18;average age:54 years;the diameter of tumor:1.2-5.6 cm,average 3.4 cm)who underwent retroperitoneal laparoscopic adrenalectomy from March 2016 to November 2019 were retrospectively analyzed in our hospital.The first step of operation:the superior retroperitoneal fold ligament was used to make a marker on the perinephric fascia as the upper border which made it accurate to locate the adrenal in the next step.Results All the operations were performed successfully after locating adrenals accurately.The average operation time was 45 min,the average blood loss was 20 ml,the average ambulation time was 12 hours,the average postoperative hospital stay was 4 days.Conclusions Using superior retroperitoneal fold ligament as an anatomic landmark to make a marker on perinephric fascia in the first step of retroperitoneal laparoscopic adrenalectomy can accurately locate adrenal.It is worth popularizing in clinical practice.

关 键 词：后腹膜返折韧带 后腹腔镜 肾上腺切除术 肾周筋膜 解剖标志 

分 类 号：R699.3[医药卫生—泌尿科学]