巨大积水肾后腹腔镜下肾切除术56例经验总结

Retroperitoneal Laparoscopic Nephrectomy for Giant Hydronephrosis （Report of 56 Cases）

【目的】总结巨大积水肾行后腹腔镜下肾切除术的经验。【方法】分析了2004年至2008年56例因巨大肾积水接受了后腹腔镜下肾切除术的病例资料。[结果]56例均在腹腔镜下完成手术。手术时间为70～180min，平均121min。所有患者均未输血，术中及术后未发生明显并发症。检查标本发现36例存在肾盂输尿管交界处梗阻，另20例巨大肾积水继发于输尿管上段结石。【结论】尽管巨大积水肾占据了大部分腹膜后腔，后腹腔镜下肾切除术仍可以安全有效地完成。

[Objective] To describe our experience with retroperitoneal laparoscopic nephrectomy for giant hydronephrosis. [Methods]The medical records of 56 patients undergoing retroperitoneal laparoscopic nephrectomy for giant hydronephrosis from 2004 to 2008 were reviewed. [Results]All procedures were successfully completed without the need for conversion to open surgery. Mean operating time was 121 minutes （range 70 to 180）. All patients did not receive blood transfusion, and there was no major complication intraoperatively or postoperatively. The etiology was congenital ureteropelvic junction obstruction in 36 patients and obstruction secondary to ureteral calculi in 20. [Conelusion]Retroperitoneal laparoscopic nephrectomy for giant hydro nephrosis can be safely performed,despite of the large amount of retroperitoneal space occupied by the hugely hydronephrotic kidneys.