单孔经腹腹腔镜肾切除术的治疗管理分析(附5例报告)

Treatment Management of Transperitoneal Laparoendoscopic Single-site (LESS) Nephrectomy(5 Cases Report)

目的探讨喀什地区开展单孔多通道经腹腹腔镜肾切除术的安全性和可行性管理分析。方法选择2014年10月—2015年8月该科完成的5例单孔多通道（Olympus Tri-Port）经腹腹腔镜下肾切除术患者,行肾功能检查,患肾均为5 ml/min,拟行肾切除术。结果摘取标本需要仅稍延长切口的情况下手术均顺利完成,平均手术时间186 min,平均术中出血50 ml。患者术后第2天胃肠道功能恢复后恢复饮食。患者术后肌酐为94-105μmol/L,术后第1、2、3天的视觉模拟疼痛评分为2/10、1/10、0/10,第3天拔出负压引流球,第5-6天出院,无任何并发症。结论单孔多通道经腹腹腔镜下肾切除术安全、可行、有效。但操作难度较高,需要一定的学习和积累,在西部有条件地区可以逐步开展,临床应用前景良好。

Objective To explore safety and feasibility management of transperitoneal laparoendoscopic single-site（LESS）nephrectomy in Kashi.Methods From 2014.10 to 2015.8,5 cases patients performed a multi-channel Tri-Port（Olympus TM） through laparoendoscopic,nephrectomy were selected in our department,all patients carried out nephric function examination,the lesion nephric was 5ml/min,which extracted through the prolonged original incision.Results The procedure was smoothly completed with the slightly-prolonged skin incision.The operating time was 186 min,with an estimated blood loss of 50 ml.The patient＇s gastrointestinal function recovered in the second day after operation.Postoperative serum creatinine level of the patient was 94μmol/L.Donor Visual Analog Pain Scores at postoperative day 1,2 and 3 were 2/10,1/10 and 0/10,respectively.The recovery of the patient was uneventful and he was discharged on the 5th postoperative day.Conclusion Transperitoneal laparoendoscopic single-site（LESS） nephrectomy was safe,feasible and effective,postoperation,less pain,rapid recovery and good cosmesis.However,the operation was more difficult and need overcoming the learning and the accumulating,which can be performed in some conditional western,and there is a good apllication future