腹腔镜下肾切除术26例临床报告

Laparoscopic nephrectomy:A clinical report of 26 cases

目的 评价腹腔镜下肾切除术的临床应用价值。 方法 应用腹腔镜行肾切除术 2 6例 ,其中经腹腔途径 19例 ,经腹膜后途径 7例。包括肾癌根治术 8例 ,肾输尿管全切术 7例 (其中肾盂癌 2例 ,输尿管癌 5例 ) ,无功能和萎缩肾 6例 ,活体供肾取肾术 5例。 结果 手术均获成功 ,手术时间 12 0～ 2 5 0min ,平均 190min ,出血量 5 0～ 2 0 0ml,平均 130ml,均未输血 ,无手术并发症。肾肿瘤 8例平均随访 16个月 ,肾输尿管全切 7例平均随访 2 0个月 ,其中 1例输尿管肿瘤局部复发 ,余均无肿瘤局部复发和远处转移。 结论 腹腔镜下行肾切除术可行 ,创伤小 ,术中出血少 ,术后恢复快。

Objective To evaluate the clinical value of laparoscopic nephrectomy. Methods Laparoscopic nephrectomy was used in 26 cases (transperitoneal approach in 19 cases and retroperitoneal approach in 6 cases), including 8 cases of radical resection of renal cancer, 7 cases of total resection of kidney and ureter (2 cases of carcinoma of renal pelvis and 5 cases of carcinoma of ureter ), 6 cases of non-functioning or atrophic kidney and 5 cases of living donor nephrectomy. Results All the operations were accomplished successfully. The operative time was 120 min ～ 250 min (mean, 190 min) and the intraoperative blood loss was 50 ml ～ 200 ml (mean, 130 ml). No blood transfusion was needed and no operative complications occurred. Follow-up for a mean of 16 months in 8 cases of renal cancer and 20 months in 7 cases of total resection of kidney and ureter revealed no recurrence or metastasis except for 1 case of local recurrence of ureteral carcinoma. Conclusions The laparoscopic nephrectomy has the advantages of minimal invasion, less blood loss and rapid recovery.