单孔后腹腔镜下肾切除术九例报告

Retroperitoneal laparoscopic nephrectomy with single-access port （report of 9 cases）

目的探讨经腹膜后入路单孔腹腔镜下肾切除术的方法。方法2009年4—10月行单孔后腹腔镜下肾切除术9例。男6例，女3例。年龄（50．9±14．1）岁。无功能积水肾5例、无功能萎缩肾1例、T1肾癌3例。左侧5例、右侧4例。气管内插管麻醉，侧卧位，切开法进入腹膜后间隙，置入自制多通道套管。经套管置人30。标准腹腔镜及操作器械行。肾切除手术。结果9例均在单孔后腹腔镜下顺利完成手术。手术时间（121．1±42．3）min，出血量（95．6±60．9）ml。术中无腹膜破裂、大出血、周围脏器损伤，术后无继发出血、切口感染、肠梗阻等并发症。术后4～6d出院。结论应用自制多通道套管行单孔后腹腔镜下肾切除手术安全可行、创伤小、切口美观。

Objective To evaluate retroperitoneal laparoscopic nephrectomy with single-access port. Methods From April 2009 to October 2009, 9 cases with renal diseases, 6 males and 3 females, aged 50.9 years, were performed retroperitoneal laparoscopic nephrectomy with single-access port. The renal lesions located in left side in 5 patients, and right side in 4 patients. The operations were done in lateral decubitus under general anesthesia. Retroperitoneal working space was setup by incision and dilation. Then the homemade multichannel single-access port was fixed in the incision. 30° standard laparoscope and instruments were introduced through the port, and the kidney were divided and resected laparoscopically. Results Nine cases of retroperitoneal laparoscopic nephreetomy were all completed by single-access port. The operation time was （121.1±42.3） min, the estimated blood loss was （95.6 ±60.9） ml. No major intraoperative complications and postoperative complications occurred. The postoperative hospital stay was 4 to 6 d. Conclusion Retroperitoneal laparoscopic nephrectomy by single-access port is feasible and safe, associated with the advantages of minimal invasive and cosmetic benefit.