后腹腔镜手术在泌尿外科的应用（附43例报告）

Retroperitoneal laparoscopy in urology （a report of 43 case ）

目的探讨后腹腔镜手术在泌尿外科的应用价值。方法应用改进的IUPU法建立腹膜后间隙，行后腹腔镜肾囊肿去顶减压术30例，肾输尿管全长切除术5例，肾上腺肿物切除术8例。结果43例手术全部成功，后腹膜腔隙建立平均需时8，7min（4～15min），术中达到满意视野，后腹腔镜肾囊肿去顶减压术、肾输尿管全长切除术、肾上腺肿物切除术平均时间分别为65、175、90min，平均出血量分别为30、150、50ml，平均住院时间分别为5、7、5d。术后1～2d排气进食，术后1～3d下床活动。1例轻度皮下气肿，1例皮下淤血，1例有囊肿残留。结论改进的IUPU法建立腹膜后间隙充分考虑了腹膜后间隙及入路的解剖特点，操作简便，可快速、安全、满意地获得后腹膜腔隙。后腹腔镜手术治疗某些泌尿外科疾病具有创伤小，恢复快、住院时间短等优势，对肾囊肿、肾孟及输尿管癌、肾上腺肿瘤为首选治疗方法。

Objective To evaluate the application value of retroperitoneal laparoscopy in urology. Methods The retroperitoneal cavity was established with new IUPU method. 30 patients underwent decompression precedure of renal cyst,5 cases experienced renal ureter resection of whole length,and 8 cases were operated on adrenal goiter resecion through retroperitoneal laparoscopy. Results AU the procedures were successfully completed. The mean time of establishing the retroperitoneal cavity was 8.7 minutes （4 -15m in ） ,in 3 groups the mean operating time was 65,175,and 90 min,the mean oprating bleeding volume was 30,150,50ml,and the mean hospital stay was 5,7,5 days ,respectivley, 1-2 days after operation,the patients were able to vent and take food,1-3 days after operation the patients were able to take acivity. 1 case developed subcutaneous emphysema, 1 case developed subcutaneous congestion and 1 case developed residual cyst. Conclusion It is simpl,easy and safe to establish the retroperitoneal cavity with this new method in retroperitoneal laparoscopy. Retroperitoneal laparoscopy is a minimally invasive technique, with advantage of quick recovery and short hospital stay.