后腹腔镜下肾血管平滑肌脂肪瘤单纯剜除术(附10例报告)

Retroperitoneal laparoscopic simple enucleation for treatment of renal angiomyolipomas(a report of 10 cases)

目的探讨后腹腔镜下肾错构瘤剜除术的手术方法及其临床价值。方法2006年4月～2008年9月,采用后腹腔镜途径对10例肾血管平滑肌脂肪瘤行单纯剜除术。沿肿瘤边缘用电钩切开肾包膜,取石钳分块夹出肿瘤组织,术中送快速病检确认为错构瘤后生物蛋白胶、止血纱布止血及可吸收线缝合肾脏创面。结果10例手术均成功完成,无中转开放者。平均手术时间87.9min,平均术中出血量55mL,平均住院时间8d。术后血肌酐、尿素氮正常。随访4～24个月,无局部肿瘤组织残留或复发。结论后腹腔镜下肾错构瘤剜除术是一种安全有效的方法,具有创伤小、出血少、恢复快、住院时间短等优点。

[Objective] To investigate the operative technique and the clinical value of retroperitoneal laparoseopie enueleation of renal angiomyolipoma （RAML）. [Methods] Between April 2006 and Sept. 2008, 10 patients with RAML underwent simple enucleation of the tumor by retroperitoneal laparoscopy. The tumor was exposed and reseeted along the edge, and the tumor was clamped out with a lithotomy forceps. The renal hamartoma was confirmed through a pathological diagnosis during the operation. Fibrin sealant and hemostatie gauze, and absorbable sutures were used to close the surgical wound in the kidney. [Results] All the operations were completed without conversion to open surgery. The mean operation time was 87.9 minutes （60-120 minutes）, the mean blood loss was 55 mL （20-120 mL）, and the mean postoperative hospital stay was 8 days （6-14） days. The renal function was normal in all the cases after the operation. The patients were followed up for 4-24 months （mean 13 months）. During this period, radiologieal examination found neither local residual tumor nor recurrent tumors. [Conclusion] Retroperitoneal laparoscopie enueleation of the renal angiomyolipoma is safe and effective, its advantages include minimal invasion, little blood loss, short hospital stay and rapid recovery.