术中超声定位在经腹腹腔镜肾部分切除中的应用

The Application of Laparoscopic Ultrasonography in Transabdominal Laparoscopic Partial Nephrectomy

目的:探究腹腔镜超声(1aprascopicultrasound,LUS)在经腹腹腔镜肾部分切除术中的应用价值。方法:我院于2010年1～6月对5例肾肿瘤患者实施LUS辅助的经腹腹腔镜肾部分切除术。术中使用LUS对肿物部位、边界、大小进行实时观测,对切缘进行检测,并评估患者手术时问、术中出血量、术后病理切缘情况等指标。结果:入组患者平均年龄49.2岁(26～67岁),肿物直径平均2.1 cm(1.5～2.5 cm),手术时间平均106.8min(98～11 4 min),出血量平均70 ml(50～100ml)。手术进展顺利.所有患者术后病理检查证实切缘均阴性。手术时间、出血量较常规手术无明显差异。结论:采用LUS术中定位对肾实质内部肿瘤及小肿瘤具有良好的动态监测作用,不但可以防止过度切除正常的肾组织,还可有效地降低切缘阳性率。此项技术值得在临床上推广使用。

Objective：To explore the application of laparoscopic ultrasbnography in transabdominal laparoscopic partial nephrectomy,and discuss the value of intraoperative laparoscopic uitrasonography. Methods： Five patients received laparoscopic ultrasonography assisted laparoscopic＇partial nephrectomy from January 2010 to June 2010 in our department. The location,size and boundary of tumor were active monitored. And indicators such as blood loss, pathology, cutting edge and so on were assessed. Results： The average age of patients enrolled was 49.2 years （26-67 years） ,and the average tumor diameter was 2. 1 cm （1. 5-2.5 cm） ,and mean operative time was 106.8 minutes（98-114 min）,and blood loss was70 ml （50-100 ml）. Surgery went successfully, all patients were confirmed negativemargins with postoperative pathology. Themean operative time,blood loss had no significant difference compared withconventional surgery. Conclusions： Laparoscopic ultrasonograpy has a unique advantage in dynamic locating the Mini-tumor or the parenchymal tumor. It can not only prevent the excessive removal of the norreal tissue,but also effectively reduce the positive margin rate. Therefore, we recommond widely use of the technology.