论文部分内容阅读
目的探讨腹腔镜下手术治疗肾移植术后上尿路肿瘤的技术方法及临床应用价值。方法11例肾移植术后上尿路肿瘤患者。男3例,女8例。平均年龄45岁(39~51岁)。肿瘤位于左侧4例,右侧7例;与移植肾同侧8例。采用后腹腔镜根治性肾切除联合经尿道膀胱袖套状切除术,手助处理输尿管下段,标本自腰部小切口取出。观察手术时间、术中出血量、住院天数、并发症及手术效果。结果11例平均手术时间150min(90~190min),术中平均出血量100ml(50~200ml),术后平均住院时间10d(9~12d),术中术后均未发生严重并发症。随访2~16个月,肿瘤无复发及远处转移。术后移植肾功能良好。结论腹腔镜辅以手助处理输尿管末段治疗肾移植术后上尿路肿瘤效果良好,具有临床推广价值。
Objective To investigate the technique and clinical value of laparoscopic surgery for upper urinary tract tumors after renal transplantation. Methods Eleven patients with upper urinary tract tumors after renal transplantation were included. 3 males and 8 females. The average age is 45 years old (39 ~ 51 years old). The tumor was located on the left side in 4 cases and on the right side in 7 cases. There were 8 cases of ipsilateral to the graft kidney. Retroperitoneal laparoscopic nephrectomy combined with transurethral cuff surgery was used to treat the lower ureter, and the specimen was removed from the small incision of the waist. Observation of operation time, intraoperative blood loss, hospitalization days, complications and surgical results. Results The average operation time was 150 min (90 ~ 190 min) in 11 patients, mean intraoperative blood loss was 100 mL (50 ~ 200 mL) and average postoperative hospital stay was 10 days (9 ~ 12 days). No serious complications occurred after operation. Followed up for 2 to 16 months, no recurrence of tumor and distant metastasis. Postoperative graft function is good. Conclusions Laparoscopy assisted with hand-assisted ureteral treatment of upper urinary tract tumors after renal transplantation with good results, with clinical value.