目的:探讨后腹腔镜下切除无功能积水肾的可行性和安全性及规避手术风险的方法。方法:对62例积水无功能肾患者行后腹腔镜积水无功能肾切除术。术前常规行肾脏CT平扫及增强检查,利用PACS系统仔细阅片,了解肾动脉分支及走向。然后建立腹膜后腔隙,参照解剖标志充分显露肾蒂血管,用Hem-o-lok夹闭肾蒂血管后切断,分离切除患肾,留置腹膜后引流管,并统计手术时间、术中出血量和术中术后并发症,观察手术效果。结果:62例患者手术均获得成功,手术时间为50~180min,平均为130min。术中出血10~100ml,平均37ml。术中损伤腹膜3例,胸膜1例,未发现血管损伤、腹腔脏器损伤等并发症。引流管于术后2~3天拔除,术后住院5~10天,平均6.5天。结论:后腹腔镜下积水无功能肾切除术安全可行,术中通过辨认解剖标志结扎肾蒂血管和沿正确的平面游离患肾是手术成功的关键。 Objective: To investigate the feasibility and safety of retroperitoneoscopic resection of non-functional hydronephrosis and to avoid the risk of surgery. Methods: Sixty-two cases of non-functional renal hydrops were treated with laparoscopic nephrectomy. Preoperative routine renal CT scan and enhanced examination, the use of PACS system carefully read the film to understand the renal artery branches and trends. The retroperitoneal lacunae were then established. Renal pedicle blood vessels were fully exposed with reference to the anatomical landmarks. After the pedicle of the pedicle of the renal pedicle was occluded with Hem-o-lok, the diseased kidneys were removed and the retroperitoneal drainage tube was placed. The operative time, intraoperative blood loss And intraoperative and postoperative complications, observe the effect of surgery. Results: All 62 patients were successful in operation. The operation time was 50 ~ 180min with an average of 130min. Intraoperative bleeding 10 ~ 100ml, an average of 37ml. Intraoperative peritoneal injury in 3 cases, 1 case of pleura, no vascular injury, abdominal organ injury and other complications. Drainage tube removed 2 to 3 days after surgery, postoperative hospital 5 to 10 days, an average of 6.5 days. Conclusions: Retroperitoneal laparoscopic nephrectomy is safe and feasible. Intraoperative identification of anatomical landmarks to ligate the pedicle of the renal pedicle and free kidney along the correct plane is the key to successful operation.