后腹腔镜半肾切除术治疗重复肾关键性技术探讨

Key points of retroperitoneoscopic heminephrectomy for the treatment of duplex kidney

目的:探讨后腹腔镜半肾切除术治疗重复肾的关键技术。方法:回顾性分析12例重复肾患者行后腹腔镜半肾切除术的临床资料,对手术中的关键性技术(重复肾的上位肾血管离断、保留部分肾实质、集合系统剥离及创面的缝合)与临床疗效进行归纳总结。结果:12例手术均成功,无中转开放手术。手术时间(153±35)min,术中出血量(80±25)mL。术后平均住院(8.5±1.5)d,漏尿1例,继发出血1例。中位随访9个月(6~36个月),尿性囊肿1例,其余患者术前原有症状消失,肾功能良好。结论:掌握重复肾后腹腔镜半肾切除术的关键技术及要点,能够提高手术成功率,降低手术并发症。

Objective:To assess key points on retroperitoneoscopic heminephrectomy for duplex kidneys.Methods:Clinical data were reviewed in 12 cases of duplex kidney treated with retroperitoneoscopic heminephrectomy,and some key points including disconnection of renal pedicle vessels,preservation of partial renal parenchyma,removal of collecting system and suture of wounds in duplex kidneys were summarized.Results:ll retroperitoneoscopic operations were successfully completed without conversion to open surgery.The mean time was(153±35)min,and the mean intraoperative blood loss was(80±25)mL.The average hospital day for patients was(8.5±1.5)days after the operation.There was 1 case of urinary leakage and 1 case of bleeding.The residual semi-kidney in all patients functioned well at a mean follow-up of 9 months(range 6 to 36).Conclusion:Mastering and using the key points for retroperitoneoscopic hemi-nephrectomy may ensure successful operation and reduce the postoperative complications.