后腹腔镜下肾错构瘤剜除术

Retroperitoneal laparoscopic enucleation of the renal hamartoma

目的:探讨后腹腔镜下肾错构瘤剜除术的手术方法及其临床价值。方法:经后腹腔镜途径对25例肾错构瘤患者进行腹腔镜下错构瘤剜除术。患者取侧卧位,后腹腔手术通过3个穿刺孔完成,暴露突出肾外部分瘤体后,沿肿瘤边缘用电钩切开肾包膜,取石钳分块夹出肿瘤组织,术中送快速病检确认为错构瘤后,用止血纱布填塞瘤体窝,“8”字缝合创面并喷洒生物蛋白胶。结果:手术均取得成功。瘤体大小为1.8cm×2.0cm^4.5cm×4.9cm,手术时间为50~90(平均70)min;术中出血30~80(平均55)mL;住院时间为7~9(平均8)d。结论:后腹腔镜下肾错构瘤剜除术是一种安全有效的方法,具有创伤小、出血少、恢复快、住院时间短等优点。

Objective To investigate the operative technique and the clinical value of retroperitoneal laparoscopic enucleation of the renal hamartoma. Methods Twenty-five patients of renal hamartoma received retroperitoneal laparoscopic enucleation. The patients were placed in lateral decubitus position. All laparoscopic surgical procedures were performed retroperitoneally using 3 portsites. The tumor was exposed and resected along the edge, and the tumor clipped out with a lithotomy forceps. The renal hamartoma was confirmed through a pathological diagnosis during the operation. The resection surface was sutured with fibrin and absorbable hemostatic gauze. Results The operations were finished successfully in all patients. The diameter of tumors ranged from 1.8 cm×2.0cm to 4.5 cm×4.9 cm. The operative time was 50 -90 （mean =70） min. The blood loss was 30-80 （mean=55） mL. The hospital stay was7-9 （mean=8） days. Condusion Retro- peritoneal laparoscopic enucleation of the renal hamartoma is safe and effective, whose advantages inelude minimal invasive, less blood loss, short hospital stay, and rapid convalescence.