后腹腔镜肾切除术23例报告

Clinical application of the retroperitoneal laparoscopic nephrectomy(report of 23 cases)

目的探讨后腹腔镜肾切除术的可行性及临床应用价值。方法2005年7月～2009年2月行后腹腔镜肾癌根治性切除术16例,肾盂癌根治性切除术3例,结核肾切除2例,萎缩肾切除2例。结果23例均获成功,无中转开放者。手术时间100～240min,平均(130±11)min;出血量40～200mL,平均(100±10)mL;术后住院时间4～7d,平均6.5d;术中及术后无明显并发症。术后病检报告:肾透明细胞癌16例,肾盂移行细胞癌3例。随访2～28个月,未见肿瘤复发及穿刺通道的种植转移。单纯肾切除亦无其他并发症。结论后腹腔镜肾切除术安全可行、疗效肯定。

Objective To investigate the feasibility and the clinical application of the retroperitoneal laparoscopic radical nephrectomy. Methods Between July 2005 to Feb. 2009, 16 patients underwent retroperitoneal laparoscopic radical nephrectomy of renal carcinoma, 3 retroperitoneal laparoscopic radical nephrectomy of renal pelvic carcinoma, retroperitoneal laparoscopic nephrectomy of renal consumption, and 2 retroperitoneal laparoscopic nephrectomy of atrophic kidney. Results All operations were performed successfully, none changed to open operation during surgery. Mean operation time was 140 min （range 100-240 min）, mean blood lose 110 mL （range 40-200 mL）. The postoperative hospital stay was 4-7 days （mean of 6.5 days）. No patients had complication during or after operation. The pathologic study reported that 16 cases were clear cell carcinoma, 3 were pelvis renalis transitional-cell carcinoma. No case of local or systemic relapse and tumor seeding of the port sites was observed during the follow-up of 2-28 months. Conclusion The retro-peritoneal laparoscopic nephrectomy is safe and effective with good clinical application.