免切割吻合器后腹腔镜下肾切除(附36例报告)

Retroperitoneal laparoscopic nephrectomy without using Endo-GIA:a clinical report of 36 cases

目的总结免切割吻合器后腹腔镜下肾切除的手术治疗方法和临床体会。方法回顾研究免切割吻合器后腹腔镜下肾脏切除手术治疗各类肾脏疾病36例,其中,肾癌3例,肾盂癌5例,肾积水无功能肾17例,肾萎缩9例,肾结核2例。结果34例手术获成功,2例因出血中转开放手术,无严重并发症发生。手术时间90～200min,平均130min;术中出血70～400mL,平均160mL,术中术后均未输血;术后8～24h进食;术后住院7～12d。结论免切割吻合器后腹腔镜下肾切除手术具有经济实用、损伤小、恢复快等优点,适宜基层医院普及开展。

[Objective] To discuss the clinical value of retroperitoneal laparoseopic nephrectomy without using Endo-GIA. [Method] A retrospective study of 36 cases who had received retroperitoneal laparoscopic nephrectomy without using Endo-GIA was made. The cases included 3 cases of renal carcinoma, 5 cases of carcinoma of renal pelvis, 17 cases of non- functioning hydronephrosis, 9 cases of non- functioning and atrophic kidney and 2 cases of renal tuberculosis. [Results] All the operations were accomplished successfully except that 2 cases underwent intra-operative conversion to open nephrectomy because of hemorrhage of the genital vein. No serious complication 6ecurred after operation. The operative time was 90-200 minutes without receiving blood transfusion. All the patients had taken food within 8~24 hours after operation and were discharged 7-12 days after operation. [Conclusion] Retroperitoneal laparoscopic nephrectomy without using Endo-GIA has the advantages of little cost, minimal invasion and rapid recovery. This technique is practical and deserves further spreading.