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目的 评价后腹腔镜肾癌根治性切除术改进后的临床效果。 方法 回顾性分阶段比较后腹腔镜肾癌根治性切除术的30例病例,探讨了后腹腔镜肾癌根治术的手术技巧和改进,比较其术中出血量及手术时间及术后恢复情况,并对病例进行随访。 结果 随著技术改进和成熟,手术时间和术中出血量明显减少,平均手术时间101±41.4 min,由最初5例平均166 min减少到最后5例平均74 min,平均术中出血量51±44 ml,由最初5例平均104 ml减少到最后5例平均26 ml。术后肠功能恢复时间平均32±18hrs、术后下床活动时间30.4±12hrs、术后住院天数5.6±1.5 d,术中及术后未发生无明显并发症,随访2～20月未见肿瘤复发与穿刺通道的种植性转移。 结论 与传统的腹腔镜根治性肾切除术相比,改进后的后腹腔镜根治性肾切除具有手术时间短,出血少,并发症少的优点。
Objective To evaluate the clinical effect of retroperitoneal laparoscopic radical nephrectomy. Methods Retrospectively compared 30 cases of radical retroperitoneal laparoscopic radical nephrectomy retrospectively, discussed the surgical techniques and improvement of retroperitoneal laparoscopic radical nephrectomy, and compared the intraoperative blood loss, operative time and postoperative recovery, The cases were followed up. Results With the improvement and maturation of technology, the operation time and intraoperative blood loss decreased significantly. The average operation time was 101 ± 41.4 min, from the first 5 to the last 5 with an average of 74 min and the mean intraoperative blood loss was 51 ± 44 ml, from an average of 104 ml in the first 5 cases to an average of 26 ml in the last 5 cases. The average recovery time of intestinal function after operation was 32 ± 18hrs, the time for getting out of bed after operation was 30.4 ± 12hrs and the number of hospital stay was 5.6 ± 1.5 days. There was no obvious complication after operation and after operation. Recurrent and puncture channels of implantable metastasis. Conclusion Compared with the traditional laparoscopic radical nephrectomy, modified retroperitoneoscopic radical nephrectomy has the advantages of shorter operation time, less bleeding and fewer complications.