改良IUPU法建立腹膜后腔的安全性及有效性

The safety and effectiveness of modified IUPU for retroperitoneal cavity

目的探讨改良IUPU法建立腹膜后腔的安全性及有效性。方法选取2016年1月至2017年12月采用改良IUPU法建立腹膜后腔并实施后腹腔镜下手术患者95例。95例手术包括根治性肾切除14例,肾上腺肿瘤切除术15例,无功能肾切除15例,肾输尿管全长切除术5例,肾囊肿去顶减压术46例。结果改良IUPU法建立腹膜后腔时间4~8(6.0±1.2)min。95例均无内脏损伤,无建腔问题改开放手术。结论改良IUPU法建立腹膜后腔简单、安全、有效,建腔时间短,值得临床运用。

Objective To evaluate the safety and efficacy of modified Institue of Urology, Peking University(IUPU) in the establishment of retroperitoneal cavity. Methods From January 2016 to December 2017, 95 cases were performed with modified IUPU technique in setting up the retroperitoneal cavity for retroperitoneal laparoscopic surgery. First, at cross point of the line 2 cm upper edge of the iliac crest and the longitudinal line close to the axillary line, a 1 cm small skin incision was made and the Veress needle was penetrated vertically through the lumbodorsal fascia after the obvious feeling a sense of frustration. the CO2 gas was pumped into retroperitoneal cavity untill the pressure increases to 14 mm Hg and inserted into the first trocar. Second, the laparoscopy was then inserted into retroperitoneal cavity and moved toward costal angle below the dorsal fascia under direct vision. The second trocar was inserted at the costal angle and the suction rod was introduced. Then the retroperitoneal fat and peritoneum were depressed to enlarge the retroperitoneal space under surveillance. Last, the third trocar was inserted into the appropriate position at the front of the axillary line. About 95 cases had been down with this technique, including 14 cases of radical nephrectomy, 15 cases of adrenal tumors resection, 15 cases of nonfunctioning kidney, 5 cases of ureteronephrectomy, 46 cases of renal cyst decortication. Results The average time was 4-8 (6.0±1.2) min by modified IUPU technique. There were no visceral injuries in 95 cases and no open surgery was performed because of the cavity defect. Conclusions The modified IUPU technique is simple, safe and effective, and it can be finished in short tie , so it is worthy of application .