后腹腔镜右肾肿瘤根治术中肾静脉的处理

The treatment of renal vein in right kidney tumor radical nephrectomy by retroperitoneal laparoscopic

目的：探讨后腹腔镜右肾肿瘤根治性切除术中肾静脉的处理方法。方法我院2008年6月至2015年2月对82例 T1~2 N0 M0期右肾肿瘤患者实施了后腹腔镜根治性肾切除，术中处理完肾动脉后，暂不对肾静脉进行处理，待完成除肾静脉以外的根治性切除后，在肾静脉得到充分显露的情况下再对其进行离断。结果82例均顺利完成后腹腔镜根治性肾切除手术，术中无肾静脉及下腔静脉损伤发生，无腹腔并发症。结论后腹腔镜右肾肿瘤根治术中采用最后处理右肾静脉的方法，即在充分暴露肾静脉及其与下腔静脉的解剖关系后对其进行离断，可有效避免血管损伤的发生，提高了手术的安全性。

Objective To explore the treatment of renal vein in right kidney tumor radical ne-phrectomy by retroperitoneal laparoscopic. Methods From June 2008 to February 201 5,82 cases of kidney cancer patients received retroperitoneal laparoscopic radical nephrectomy. First amputation surgery renal artery,then radical nephrectomy,the last fully free and fully exposed vein after tran-section. Results The 82 cases were successfully completed retroperitoneal laparoscopic radical ne-phrectomy,without renal vein or inferior vena cava injury and peritoneal complications. Conclu-sions In radical nephrectomy by retroperitoneal laparoscopic,first amputation surgery renal artery, then radical nephrectomy,the last fully free and fully exposed the renal vein and inferior vena cava after transection. This method can effectively avoid the occurrence of vascular injury and improve the safety of surgery.