后腹腔镜下肾癌根治术(附43例报告)

Retroperitoneal laparoscopic radical nephrectomy(43 cases)

目的探讨后腹腔镜下肾癌根治术的手术方法及技巧。方法其中男26例,女17例,年龄34～78岁,平均年龄58岁。左侧23例,右侧20例。肿瘤直径2.0～6.5cm,平均3.5cm。所有患者均行后腹腔镜下肾根治性切除。结果所有手术均顺利完成,无1例改开放,术中及术后未发生严重并发症。手术时间50～120min,平均75min。术中出血50～200ml,平均80ml,1例患者因术前即有贫血,术后输血400ml。术后住院时间5～9d,平均6.5d。术后病理均证实为肾细胞癌,随访2个月～5年余,1例术后1年腹膜后淋巴结转移死亡,1例术后2年出现肝转移死亡,其余均存活。结论后腹腔镜下肾癌根治术是有效、安全的治疗方法,掌握适当的手术适应证,通过改良的手术方法及熟练的手术技巧可以确保手术的效果。

Objective To discuss methods and skills of retroperitoneal laparoscopic radical nephrectomy. Methods Clinical materials and operation approaches of 43 cases were summed up re- spectively from September 2005 to June 2010. Results All patients underwent the retroperitoneal laparoscopic radical nephrectomy successfully. The mean time was 75 min （from 50 to 120 min）. Postoperative pathological results were all renal-cell carcinoma. Conclusions Retroperitoneal laparoscopic radical nephrectomy is an effective and safe alternative treatment, and appropriate indication, improved procedure and skillful operation could assure the effectiveness of operation.