后腹腔镜结核性无功能肾切除术的临床体会

Clinical experience of retroperitoneoscopic nephrectomy for nonfunctioning tuberculous kidneys

目的:探讨后腹腔镜肾切除术治疗无功能性肾结核的临床应用价值。方法:2008年9月至2011年9月为32例肾结核患者行后腹腔镜结核性肾切除术。术中使用超声刀游离肾脏与输尿管,阻断肾蒂,切除的肾脏放入肾袋取出。手术前、后均行正规抗结核治疗。结果:32例手术均获成功,无一例中转开放手术。手术时间90～200 min,平均130 min;术中出血量30～140 ml,平均60 ml;术后住院5～9 d,平均7.1 d;术中、术后无明显并发症发生。结论:后腹腔镜肾切除术治疗结核性无功能肾安全、有效、微创,为肾结核的手术治疗提供了新途径。术前需积极进行抗痨治疗,术中科学、合理、仔细操作。

Objective：To explore the clinical efficacy of retroperitoneoscopic nephrectomy for nonfunctioning tuberculous kidneys.Methods： From Sep.2008 to Sep.2011,retroperitoneoscopic nephrectomy was performed in 32 patients with tuberculous nonfunctioning kidneys.During operation,ultrasound knife was used to separate kidney and ureter,renal pedicle was blocked,and resected kidney was put in bag and removed.Clinical data of these patients were analyzed retrospectively.Antituberculosis therapy was carried out before and after surgery.Results：Retroperitoneoscopic nephrectomy was successfully performed in all patients without conversion to open surgery.The operation time ranged from 90 to 200 min with a mean of 130 min.Mean intraoperative blood loss was 60 ml（range,30-140 ml）.Postoperative hospital stay was 5 to 9 d（mean,7.1 d）.No significant complication was identified during and after operation.Conclusions：Retroperitoneoscopic nephrectomy for tuberculous nonfunctioning kidney is safe,effective and mini-invasive.Retroperitoneoscopic nephrectomy should be regarded as the choice of treatment for tuberculous nonfunctioning kidneys.Before operation,antituberculosis therapy should be positively carried out,operations should be scientific,reasonable and careful.