10例后腹腔镜手术腹膜破裂的处理

Retroperitoneal laparoscopic surgery for peritoneal rupture in 10 cases

目的分析后腹腔镜手术中腹膜破裂的原因及处理方法。方法回顾2011年1-12月我科部分后腹腔镜手术资料,共10例发生腹膜破裂,其中男6例,女4例,年龄18~65岁,平均43岁,包括肾上腺部分切除术2例,肾部分切除术1例,根治性肾切除术4例,肾盂成型术1例,肾输尿管全长切除术2例。结果 10例腹膜破裂的原因包括患者本身体质、操作技术、解剖标识不清、术者急躁等。破损腹膜处理方法包括：直接夹闭,腹腔套管排气和器械阻挡腹膜保证空间。结论大部分腹膜破裂可以避免,掌握腹膜处理技巧有助于保证手术顺利完成。

Objective To analyze the reasons for peritoneal rupture and its retroperitoneal laparoscopic surgery.Methods Clinical data about 10 patients（6 males and 4 females） aged 18-65 years（mean 43 years） who underwent retroperitoneal laparoscopic surgery for peritoneal rupture in our hospital from January 2011 to December 2011 were retrospectively analyzed.Of the 10 patients,2 underwent partial adrenalectomy,1 partial nephrectomy,4 radical nephrectomy,1 pelvis shaping,and 2 nephroureterectomy.Results The reasons for peritoneal rupture included the patients＇ body condition,operating skills,anatomic marking ambiguity and impatience of the operator.The managing methods for peritoneal rupture included direct occlusion,evacuating gas from abdominal cavity and protection of peritoneum.Conclusion Peritoneal rupture can usually be avoided and good operating skills for peritoneum contribute to the success of retroperitoneal laparoscopic surgery.