腹腔镜在泌尿外科手术中的应用

Application of Laparoscopy in Urologic Operation

目的：探讨后腹腔镜在治疗肾上腺、肾脏、输尿管等脏器疾病中的临床效果。方法：自2004年1月～2007年2月采用后腹腔镜手术治疗泌尿系疾病84例，其中肾上腺肿瘤及肾上腺囊肿切除26例，肾囊肿去顶术33例，单纯肾切除10例，肾癌根治性切除3例，肾输尿管全切1例，乳糜尿行肾蒂淋巴管结扎术5例，输尿管上段切开取石4例，肾盂输尿管成形术2例。结果：79例成功，中转开放手术5例。手术时间40～130min，平均（82．3土56．7）min,术中出血20～150mL。患者术后1、2d能下床活动，术后住院时间3～10d，平均（5．5±2．5）d。无严重并发症发生。结论：后腹腔镜手术与开放手术相比具有创伤小、出血少、康复快、安全性高、并发症少等优点，临床疗效可靠，具有良好的应用前景，但必须掌握适应证。

Objective： To investigate the clinical effects of retroperitoneal laparoscopic surgery in Urology. Methods： Eighty-four patients with urological diseases were operated by means of laparoscopic surgery from January 2004 to February 2007. They included 26 cases of adrenal tumor surgery, 33 cases of renal cyst decortication, 10 cases of simple nephrectomy,3 cases of radical nephrectomy,1 case of nephroureterectomy, 5 cases of renal pedicle lymphatic disconnection for chyluria, 4 cases of ureterolithotomy,2 cases of pyeloplasty or ureteroplasty. Results：Seventynine cases accomplished laparoscopic surgery,5 cases converted to open surgery. The operation time lasts 40-130 minutes, with an average of （82.3±56.7）rain. The hemorrhage amount in operation was 20- 150 mL. At 2 days after operation patients were able to walk around. The patients＇ hospital stay was 3-10 d, with an average of （5.5±2.5） d. There were no serious complications in these cases. Conclusion：Compared with open surgery, laparoscopic surgery has the advantages of minimal invasion, less blood loss, quicker recovery, safe and less complication, which has a good applied future in the urologic clinical practice.