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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 investigate the safety and feasibility of single hole multi-channel laparoscopic nephrectomy in Kashgar region. METHODS: From January 2014 to August 2015, 5 patients undergoing laparoscopic radical nephrectomy in 5 cases of monocular multi-channel (Olympus Tri-Port) were enrolled in this study. Renal function tests were performed on all patients with a kidney volume of 5 ml / min , Proposed nephrectomy. Results The specimens were removed successfully with a slight incision. The average operation time was 186 min and the average intraoperative bleeding was 50 ml. On the second postoperative day, the patient’s gastrointestinal function was restored and the diet was resumed. The postoperative creatinine was 94 ~ 105μmol / L, visual analogue pain score was 2 / 10,1 / 10,0 / 10 on the 1st, 2nd, 3rd day after operation. ~ 6 days discharged without any complications. Conclusions Single hole multi-channel laparoscopic nephrectomy is safe, feasible and effective. However, it is difficult to operate and requires some learning and accumulation. It can be gradually carried out in the western part of the country and the clinical application is promising.