后腹腔镜二孔法肾囊肿去顶术30例体会

Clinical research of retroperitoneal laparoscopic renal cyst unroofing(report of 30 cases)

目的探讨后腹腔镜二孔技术肾囊肿去顶减压术治疗肾囊肿的临床效果。方法采用腋中线髂棘上2cm切口,置入气腹针达腹膜后间隙,充气压力达14mmHg后置入1cm套管,放入腹腔镜,利用镜体钝性分离腹膜后间隙,在腹腔镜监视下于腋前线肋下再置入一根1cm工作套管,行肾囊肿去顶术共30例。结果30例手术全部成功,无1例中转开放手术。无皮下气肿,手术20～40min,平均住院4.5d。结论后腹腔镜二孔技术肾囊肿去顶术避免了操作钳与摄像镜相互干扰,少戳一孔,创伤进一步减小,操作更便捷,值得推广。

[Objective] To evaluate the clinical effection of retroperitoneal renal cyst unroofing. [Methods] The incision of abdominal wall is 2 cm above the anterior superior iliac spine at the middle axillary hne. Put laparotomy in retropenritoneal space with the pressure of 14 mmHg and put a canulaof lcm in it. After separating retroperitoneal space by using the aparoscope, put another eanula under the rib at the anterior axillary line, monitoring with laparoscope. Renal cyst unroofing of 30 cases was performed. [Results] All 30 cases were treated successfully with retroperitoneal laparoseopy, no cases was required whereas concersion to open adrenalectomy, no subcutaneous emphysema. The operation time ranged from 20 to 40 minutes. The mean hospital stay was 4.5 days. [Conclusion] The retroperitoneal laparoseopic avoid the interference of the operating forceps and photomicroscope, one fewer hole, less injury and pain, quicker, can be recommended.