腹腔镜手术治疗泌尿系统疾病的价值

Value of laparoscopic surgery on urologic diseases

为综合评价腹腔镜手术治疗泌尿系统疾病的价值 ,对 111例采用腹腔镜手术治疗的泌尿系统疾病患者的手术时间、疗效及并发症等进行了综合分析。结果显示 ,手术成功者 10 8例 ,3例术中改开放手术。手术时间分别为肾囊肿切除术 15～ 12 0分钟 ,肾切除术 12 0～ 3 0 0分钟 ,肾上腺肿瘤切除术 12 0分钟 ,肾盂癌输尿管癌根治术 180～ 2 80分钟 ,输尿管切开取石术 10 0分钟 ,肾盂成形术 2 5 0分钟 ,隐睾探查切除术 3 0～ 5 0分钟 ,多囊肾多囊去顶术40～ 12 0分钟 ,精索内静脉高位结扎术 15～ 60分钟。术后下床时间 2 4～ 48小时 ,住院 2～ 7天。术后随访 3个月至 4年余 ,未见原发病复发 ,无严重近远期并发症。表明腹腔镜手术治疗泌尿系统良性和部分恶性疾病安全可靠 ,其最大优点是手术切口小、损伤小。

To evaluate the clinical value of the laparoscopic surgeries on urologic diseases,the operating time,clinical efficacy and perioperative complications of laparoscopic procedures on 111 cases were analysed. The procedures of 108 cases were successful,while 3 cases were converted to open surgery.The operating time was 15～20min in unroofing of renal cysts,120～300min in simple nephrectomy,120min in removal of adrenal gland tumor,180～280min in radical nephroureterectomy,100min in ureterolithotomy,250min in pyeloureteroplasty,30～50min in removal of the undescended testicles,40～120min in multiple cystic decortication of polycystic kidney disease,15～60min in ligation of spermatic vessels,respectively.The average hospitalization time was 2～7d,the postoperation ambulation time was 24～48h.There were no serious morbidity in perioperative period,and there were no any obvious complications occurred in the 3 months to 4 years follow up.These suggest that the minimally invasive laparoscopic surgery in some benighn and selected malignant urologic diseases are safe and reliable,the most advantages of the laparoscopic surgery are small incision,minimal injury,and postoperation recovery quickly.