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目的:探讨后腹腔镜重复肾切除的可行性和疗效。方法:2005年6月～2010年10月行后腹腔镜下重复肾切除术17例,其中男5例,女12例,年龄12～72岁,平均40.4岁。1 7例均位于肾上极。2例因体检发现肾积水就诊;12例因腰痛伴发热就诊;3例因尿失禁就诊。17例患者均术前行磁共振尿路水成像(MRU)、IVU或CT片确诊重复肾,16例重复肾位于左侧,1例患者为右侧重复肾伴积水左侧肾缺如,行右肾穿刺造瘘术。结果:16例手术时间80～200 min,平均110 min。出血量40～400 ml,平均70.5 ml。术中转开放手术1例;术中损伤正常肾盂肾盏2例。术后肠道功能恢复时间1～3.5天,平均2天,术后住院时间6～8天,平均7天。术前平均血尿素氮(5.8±1.1)mmol/L,血肌酐(70.4±26.5)μmol/L。术后随访3个月,平均血尿素氮(6.0±1.0)mmol/L,血肌酐(81.8±1 9.2)μmol/L。两组差异无统计学意义(P>0.05)。患者术前原有症状消失,术后3～24个月B超复查均未见重复肾。结论:后腹腔镜重复肾切除术安全可靠,疗效良好,患者恢复速度快。
Objective: To investigate the feasibility and efficacy of retroperitoneal laparoscopic nephrectomy. Methods: From June 2005 to October 2010, 17 cases underwent laparoscopic retroperitoneal nephrectomy, including 5 males and 12 females, aged from 12 to 72 years (average 40.4 years). 1 7 cases are located in the kidney pole. Two cases were diagnosed with hydronephrosis because of physical examination; 12 cases were treated with fever due to back pain; three cases were treated by incontinence. All the 17 patients underwent MR urography, IVU or CT scan of the kidney, 16 cases of the duplicated kidneys were located on the left side, 1 case was the right side of the kidney with water left side of the left kidney, Right renal puncture fistulation. Results: The operation time of 16 cases was 80-200 min with an average of 110 min. Bleeding volume 40 ~ 400 ml, an average of 70.5 ml. Surgery in 1 case of open surgery; intraoperative normal renal pelvis calyx in 2 cases. Postoperative intestinal function recovery time of 1 to 3.5 days, an average of 2 days, postoperative hospital stay 6 to 8 days, an average of 7 days. Preoperative average blood urea nitrogen (5.8 ± 1.1) mmol / L, serum creatinine (70.4 ± 26.5) μmol / L. The patients were followed up for 3 months. The average blood urea nitrogen (6.0 ± 1.0) mmol / L and serum creatinine (81.8 ± 1 9.2) μmol / L were obtained. There was no significant difference between the two groups (P> 0.05). Patients with preoperative symptoms disappeared, 3 to 24 months after the B-ultrasound did not see repeated renal. Conclusions: Retroperitoneal laparoscopic nephrectomy is safe and reliable with good curative effect and rapid recovery.