后腹腔镜手术在基层医院泌尿外科的应用

Retroperitoneal laparoscopic surgery in the application of urology:a primary hospital experience

目的 总结基层医院泌尿外科开展后腹腔镜手术的价值、技巧和经验.方法 回顾性分析应用用后腹腔镜手术治疗81例泌尿外科疾病患者的临床资料.结果 79例手术成功,1例肾上腺肿瘤因大出血中转开放手术,1例肾囊肿术后活动性出血转开放手术止血.手术时间0.5～7.5 h,平均2.5 h,术后无其他严重并发症发生,术后住院2～14 d,平均5.5 d.结论 后腹腔镜手术治疗泌尿外科疾病具有创伤小、术后恢复快、并发症少、住院时间短且疗效显著等优点,值得在基层医院推广应用;只要遵循由易到难、循序渐进的原则,严格掌握手术适应证及禁忌证,同时认真对待开展初期存在的诸多困难和问题,基层医院亦能顺利开展后腹腔镜手术.

Objective To evaluate the applicability and experience of retroperitoneal laparoscopic operation in primary hospital. Methods The clinical data of 81 patients that underwent urologic surgery by retroperitoneal laparoscopy were retrospectively collected and analyzed. Results The surgeries were successful in 79 cases. One ease of adrenal neoplasm was converted to open surgery because of heavy bleeding during operation. Another case of renal cyst was converted to open surgery due to active bleeding post operation. The average time for operation was 2.5 h （ranged 0.5-7.5 h）. No severe complication was observed after operation. The average hospitalized time post-operation was 5.5 d （ranged 2-14 d）. Conclusion Retroperitoneal laparoscopy is a suitable choice for urologic operations in primary hospitals, with the advantages of minimal invasion, rapid recovery, less complication and short hospitalization days. The step-wise progression from basic to advanced techniques, the optimal screening of candidate through indications and contraindications, and pro-active problem solving is essential at the initial stage.