双平面改良暴露法在后腹腔镜技术治疗肾上腺疾病的临床应用

Research on the modified method of dual plane surgical exposition in retroperitoneal laparoscopy for adrenal disease

目的探讨双平面改良暴露法在后腹腔镜技术治疗肾上腺疾病的临床应用价值。方法回顾性分析2007年12月至2010年12月期间采用双平面改良暴露法进行经后腹腔镜技术治疗肾上腺疾病的23例患者临床资料。结果23例中19例手术成功采取双平面改良暴露法，4例需中转为传统暴露方法；手术时间35—80min，术中出血量20—100ml，术中、术后均未发生严重的并发症。结论采取仅在上半肾腹侧的肾周脂肪囊与。肾固有筋膜间、肾周脂肪囊与Gerota筋膜间此双平面分离的改良暴露方法亦可快速安全暴露肾上腺。

Objective To explore the modified method of dual plane to expose adrenal gland in retroperitoneal laparoscopy for adrenal disease. Methods The clinical data of 23 cases with adrenal dis- ease who underwent retroperitoneal laparoscopy by dual plane surgical exposition at our hospital during December 2007 to December 2010 were analyzed retrospectively. Results 19 of the 23 cases were suc- cessfully finished with the modified method of dual plane surgical exposition. 4 of the 23 cases were turned into the conventional method of triple plane surgical exposition.The surgical time was 35-80 minutes,the volume of blood loss was 20-100 ml. None of the 23 cases was suffered with severe complication. Conclu- sion The adrenal gland can be quickly and safely exposed with the modified method of dual plane, by dis- sociating between upper perinephric fatty capsule and renal fibrous capsule, between perinephric fatty cap- sule and gerota fascia.