改良背部直切口在后腹腔镜肾切除术中的应用

Application of modified lumbodorsal vertical incision in retroperitoneal laparoscopic nephrectomy

目的探讨改良背部直切口在后腹腔镜肾切除术中应用的技术方法和临床价值。方法2012年3月至2014年6月，江西省人民医院施行88例后腹腔镜肾切除术，男性49例，女性39例。年龄22～76岁，其中肾肿瘤52例，肾结核9例，肾错构瘤1例，无功能肾并铸型结石26例，均采用改良背部直切口取出标本。结果本组88例手术均成功，无中转开放病例，未出现大血管或邻近脏器损伤等术中并发症，手术切口均一期愈合，无切口疝。手术时间50～145min，术中失血量30～250ml，术中均未输血。术后引流管留置时间2～4d，术后1～3d下床。结论改良背部直切口用于手术标本的取出是传统开放手术技巧与现代腹腔镜微创技术的有效结合，具有创伤小、疼痛轻、切口并发症少、恢复快等优点。

Obijective To evaluate the feasibility and clinical efficacy of modified lumbodorsal vertical incision in retroperitoneal laparoscopic nephreetomy. methods 88 patients underwent retroperitoneal laparoscopic nephrectomy, including 49 men and 39 women from March 2012 to June 2014. The age ranged from 22 to 76 years. There were 52 cases of renal tumor, 9 cases of tuberculous pyonephrosis, 1 case of renal hamartoma and 26 cases of non-functioning kidney with staghom calculi. All cases were performed with modified lumbodorsal vertical incision for specimen retrieval. Resuit All 88 operations were performed successfully. No procedures were converted to open surgery, no intraoperative complications such as large vessels or organ damages occured. One-stage incision healing were achieved in all paticents, no incision hernia occured. The operative time was 50-145 min, the estimated blood loss was 30-250 ml. No patients needed blood transfusion. The indwelling time of drainage tube was 2-4 days postoperative. The activity time was 1-3 days. Conclusion The modified lumbodorsal vertical incision which are effective combines traditional open surgery skills and modem laparoscopic techniques, as specimen retrieval approach offers advantages of less trauma, less postoperative pain, fewer complications of incison and quicker recovery.