后腹腔镜辅助小切口肾输尿管及膀胱袖套状切除术(附7例报告)

Radical nephroureterectomy and bladder cuff excision with short incision assisted by retroperitoneal laparoscopy:a report of 7 cases

目的：探讨后腹腔镜辅助小切口肾输尿管及膀胱袖套状切除术的手术技巧.方法：用后腹腔镜辅助小切口为7例肾盂及输尿管肿瘤患者行肾输尿管及膀胱袖套状切除术,其中肾盂癌4例,输尿管癌3例.结果：7例手术均获成功,手术时间90～120min,平均108min,术中出血50～150ml,平均80ml.术后平均住院10d,无严重并发症发生.随访4～33个月,无肿瘤复发.结论：采用后腹腔镜辅助小切口肾输尿管及膀胱袖套状切除术治疗肾盂及输尿管肿瘤具有患者创伤小、出血少、手术时间短、并发症少、切除更完全等优点.

Objective：To evaluate the technique of radical nephroureterectomy and bladder cuff excision with short incision assisted by retroperitoneal laparoscopy. Methods：Seven patients including four patients with renal pelvic carcinoma and 3 patients with carcinoma of ureter underwent radical nephroureterectomy and bladder cuff excision with short incision assisted by retroperitoneal laparoscopy. Results：All the operations were successful. The mean operating time was 108min （range from 90 to 120min） ,the mean blood loss was 80ml （range from 50 to 150ml）, and the mean postoperative hospitalization was 10d. No severe complications occurred. There was no recurrence with a follow-up of 4-33 months. Conclusions ： Radical nephroureterectomy and bladder cuff excision with short incision assisted by retroperitoneal laparoscopy has advantages of minimal invasion, less blood loss, fewer complications, short hospitalization and complete resection for carcinoma in renal pelvis and ureter.