洞穴式切口泌尿外科手术68例报告

Port-access approach for urosurgical operation ( report of 68 cases)

目的探讨洞穴式切口进行输尿管肾盂切开取石术、肾囊肿去顶减压术的方法、特点及适应证等。方法68例患者,其中输尿管结石43例、肾盂结石5例、单纯肾囊肿15例及多囊肾5例。在平均3．4 cm的切口中利用洞穴式手术器械暴露获得锥形手术视野,直视下进行输尿管肾盂切开取石术、肾囊肿去顶减压术,对洞穴式手术器械的应用、手术方法、疗效及适应证等进行介绍。结果68例手术均成功,手术时间平均71 min,术中平均出血20 ml,术后住院平均6 d。随访3-12个月无并发症和复发。结论洞穴式切口输尿管肾盂切开取石术及肾囊肿去顶减压术具有直视下操作、安全、创伤小、恢复快、适应证宽等优点。

Objective To evaluate the operative methods,characteristics and indications for portaccess approach in performing ureterolithotomy, pyelolithotomy and unroofing of solitary renal cyst. Methods This series consisted of 68 cases,including 43 cases of ureteral stones,5 of renal pelvic stones, 15 of simple renal cyst and 5 of polycystic kidney. Using the apparatus of the port-access for urosurgical operation to expose the taper view, we performed pyelolithotomy, ureterolithotomy and unroofing of solitary renal cyst optically. The length of the incision was 3.4 cm on average. The apparatus＇ application,surgical technique, curative effect and indications were analyzed. Results All the procedures were successful in the 68 cases. The mean operative time was 71 min;mean blood loss was 20 ml,and mean hospitalization was 6 d. Neither complication nor recurrence was found during the follow-up for 3 - 12 months. Conclusions Port-access approach for urosurgical operation has advantages of operation under direct vision, minimal invasion, safety ,rapid recovery and wider indications. It is a new treatment choice for minimally invasive urology.