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目的:探讨后腹腔镜肾癌根治术的手术经验和临床效果。方法:2006年1月至2007年12月,后腹腔镜肾癌根治术67例。男44例,女23例。年龄23~80岁,平均52岁。肿瘤位于右侧35例,左侧32例;位于肾上极15例,中极29例,下极23例。肿瘤直径1.5~8.0 cm,平均4.64 cm。术前肿瘤分期:T1N0M064例,T2N0M03例。结果:手术时间为55~253 min,平均110 min。术中出血10~500 ml,平均98 ml,前10例平均出血152 ml,后10例平均出血量仅58 ml。术后住院7~12 d,平均8 d。术后肠功能恢复时间1~2 d。术后随访2~26个月,平均12.1个月。无局部复发或远处转移,无切口或操作孔肿瘤种植。结论:后腹腔镜肾癌根治术具有微创、出血少、术后恢复快等优点,是一种安全、可靠的手术方法。
Objective: To investigate the surgical experience and clinical effect of retroperitoneal laparoscopic radical nephrectomy. Methods: From January 2006 to December 2007, 67 patients underwent laparoscopic radical nephrectomy. 44 males and 23 females. Age 23 to 80 years old, average 52 years old. The tumor was located on the right side in 35 cases and on the left side in 32 cases. It was located in the upper pole of the kidney in 15 cases, the middle pole in 29 cases and the lower pole in 23 cases. Tumor diameter 1.5 ~ 8.0 cm, an average of 4.64 cm. Preoperative tumor staging: T1N0M064 cases, T2N0M03 cases. Results: The operation time was 55 ~ 253 min with an average of 110 min. Intraoperative bleeding 10 ~ 500 ml, an average of 98 ml, the average bleeding in the first 10 cases of 152 ml, the average bleeding after 10 cases only 58 ml. Postoperative hospitalization 7 ~ 12 d, an average of 8 d. Postoperative bowel function recovery time of 1 ~ 2 d. The patients were followed up for 2 to 26 months with an average of 12.1 months. No local recurrence or distant metastasis, no incision or operation hole tumor planting. Conclusions: Retroperitoneal laparoscopic radical nephrectomy is a safe and reliable surgical method with the advantages of minimal invasion, less bleeding and quick recovery after operation.