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目的 :探讨手助腹腔镜在肾输尿管全长切除术加膀胱袖套状切除术中的应用价值。方法 :采用手助腹腔镜行肾输尿管全长切除术 ,加膀胱袖套状切除术治疗上尿路移行细胞肿瘤 7例 (其中经腹腔途径 5例 ,经腹膜后途径 2例 )。病理类型均为移行细胞癌 (肾盂移行细胞癌 5例 ,输尿管移行细胞癌 1例 ,肾盂和输尿管多发性移行细胞癌 1例 )。结果 :7例手助腹腔镜手术均获成功。手术时间 5 0～ 15 0min ,平均 97.5min ;术中出血 5 0～30 0ml,平均 111.4ml;术后住院时间 7～ 5 3d。结论 :采用手助腹腔镜行肾输尿管全长切除术加膀胱袖套状切除术治疗上尿路移行细胞癌 ,是一种可选择的新的手术方式 ,与开放手术相比 ,具有损伤小、出血少、术后恢复快等优点。
Objective: To explore the value of hand-assisted laparoscopy in total nephroureterectomy and cuff cuff resection. Methods: 7 cases of upper urinary tract transitional cell carcinoma were treated with manual assisted laparoscopic radical nephroureterectomy and sleeve cuff resection of the upper urinary tract (5 cases were transperitoneally and 2 cases were retroperitoneally). The pathological types were transitional cell carcinoma (renal pelvis transitional cell carcinoma in 5 cases, ureter transitional cell carcinoma in 1 case, renal pelvis and ureteral multiple transitional cell carcinoma in 1 case). Results: Seven cases of hand assisted laparoscopic surgery were successful. The operation time ranged from 50 to 150 min, with an average of 97.5 min. The intraoperative blood loss ranged from 50 to 300 mL with an average of 111.4 mL. The postoperative hospital stay was from 7 to 5 days. Conclusion: The hand-assisted laparoscopic radical nephroureterectomy combined with cuff cuff surgery in the treatment of upper urinary tract transitional cell carcinoma is an alternative new surgical approach, compared with open surgery, with less injury, Less bleeding, quick recovery and so on.