摘要
目的总结本组腹腔镜根治性肾切除术的经验和技术特点，评价该手术的安全性及疗效。方法回顾性分析2004年3月-2012年3月首都医科大学附属北京友谊医院泌尿外科实施的600例腹腔镜根治性肾切除术患者的临床资料。经后腹腔途径560例，经腹腔途径40例。男380例，女220例。平均年龄55岁（16～84岁）。左侧314例，右侧286例。T1N0M0 511例，T2N0M0 74例，T3N0M0 15例，肿瘤直径2．8—10．5cm。10例伴有静脉癌栓，左肾静脉癌栓8例，右腔静脉癌栓2例。结果因术中严重出血和分离困难而中转开放13例，平均手术时间110min（70～320min），平均术中出血量90mL（30～830mL）。术后肠功能恢复平均时间23h（19～43h），术后平均住院时间7d（5．5～10d）。术后拔除引流管平均时间50h（36—72h）。输血15例，术后4例患者发生严重并发症。结论腹腔镜根治性肾切除术是一种安全、有效的治疗方法，随着经验的积累，其手术适应证也不断扩大。
Objective To report the author＇ s experience with the laparoscopic radical nephrectomy and eraluate it＇s saftey and therapy. Methods The retrospective analysis was performed on 600 consecutive patients undergoing laparoscopic radical nephrectomy in the author＇ s institute from March 2004 to March 2012. There were 380 male and 220 female patients with the average age of 55 years （ 16 - 84 years）. Five hundred and sixty cases and 40 cases underwent retroperitoneal and transperitoneal surgery respectively. The operative time, estimated blood loss ,postoperative hospital stay, complications and the time of complete convalescence were recorded. Results Thirteen cases were converted to open surgery due to severe adhesion and severe bleeding. The mean operative time was 110 min（70-320 min）. The medium estimated blood loss was 90 mL（30 -830 mL） and 15 cases required blood transfusion. The mean drainage time was 50 h（36 -72 h） ,the mean time to first oral intake was 23 h（ 19 - 43 h） and the mean postoperative hospital stay was 7 d（5.5 - 10 d）. There were 4 patients with severe complication. Conelusion Laparscopic radical nephrectomy is safe and effective. It has been the standard therapeutic modality for localized renal cell carcinoma.
出处
《国际外科学杂志》
2012年第10期665-668,共4页
International Journal of Surgery
关键词
肾肿瘤
肾切除术
腹腔镜
Kidney neoplasms
Nephrectomy
Laparoscopes
