[1]罗康平,马潞林,黄毅,等.后腹腔镜根治性肾切除术126例报告[J].中国微创外科杂志,2007,07(3):245-246.
　Luo Kangping,Ma Lulin,Huang Yi,et al.Retroperitoneal laparoscopic radical nephrectomy: Report of 126 cases[J].Chinese Journal of Minimally Invasive Surgery,2007,07(3):245-246.
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后腹腔镜根治性肾切除术126例报告()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
07
期数:
2007年3期
页码:
245-246
栏目:
出版日期:
2007-03-20

文章信息/Info

Title:
Retroperitoneal laparoscopic radical nephrectomy: Report of 126 cases
作者:
罗康平; 马潞林; 黄毅; 张树栋; 田晓军; 侯小飞; 赵磊; 卢剑; 洪锴
北京大学第三医院泌尿外科，北京100083
Author(s):
Luo Kangping;  Ma Lulin;  Huang Yi;  et al.
Department of Urology, Peking University Third Hosptital, Beijing 100083, China
关键词:
腹腔镜; 肾切除术
Keywords:
Laparoscopy; Nephrectomy
分类号:
R699.2
文献标志码:
A
摘要:
目的探讨后腹腔镜下根治性肾切除术的疗效。方法2002年11月～2006年6月行后腹腔镜下根治性肾切除术126例。取腰部3个穿刺点入路，肾动脉和静脉均用Hemolok夹闭后切断，输尿管在近髂血管处切断。结果2例因出血，1例因粘连较重，中转开放手术。平均手术时间115 min（60～255 min）；平均术中出血量112 ml（20～1000 ml），2例须输血。并发症7例（精索静脉损伤1例，副肾动脉损伤1例，下腔静脉损伤1例，肾动脉残端出血1例，肾静脉损伤2例，胰尾损伤1例）：1例腔静脉损伤，术后随访2年，对健康无影响；1例胰尾漏术后随访1年，肾窝无积液，无胰腺炎；余５例并发症恢复顺利无异常。术后平均住院5 d（4～8 d）。病理报告：117例肾透明细胞癌，3例囊性肾细胞癌，2例肾盂移行细胞癌，1例嫌色细胞癌，2例错构瘤， 1例嗜酸细胞瘤。1例肾癌术后半年发现肝转移，术后1年因肝转移死亡；其余125例平均随访27个月（1～43个月），未发现肾窝及切口转移，未发现远处转移，无瘤生存。结论后腹腔镜下根治性肾切除术安全可靠，疗效良好。
Abstract:
ObjectiveTo evaluate the efficacy of retroperitoneal laparoscopic radical nephrectomy.MethodsA total of 126 patients underwent retroperitoneal laparoscopic radical nephrectomy from November 2002 to June 2006. The operation was performed through 3 lumbar ports. The renal artery and veins were blocked with the Hemolok and then severed; the ureter was severed near the iliac blood vessel.ResultsA conversion to open surgery was required in 2 patients because of bleeding and in 1 patient because of severe adhesion. The mean operation time was 115 min (range, 60~255 min) and the mean blood loss was 112ml (range, 20~1000 ml). Blood transfusion was required in 2 patients. Complications occurred in 7 patients (spermatic vein injury in 1 patient, accessory renal artery injury in 1 patient, inferior vena cava injury in 1 patient, hemorrhage of renal artery stump in 1 patient, renal vein injury in 2 patients, and pancreatic tail injury in 1 patient). The patient with inferior vena cava injury was followed for 2 years and no abnormal findings were found. The patient with pancreatic tail leakage was followed for 1 year and no pancreatitis or liquid in the renal fossa was detected. The remaining 5 patients with complications presented no abnormal findings. The mean postoperative hospital stay was 5 days (range, 4~8 days). Pathological results included renal clear cell carcinoma in 117 patients, cystic renal cell carcinoma in 3 patients, renal pelvis transitional cell carcinoma in 2 patients, chromophobe carcinoma in 1 patient, hamartoma in 2 patients, and oxyphil cell tumor in 1 patient. One patient developed a liver metastasis 6 months after operation, and died 1 year after operation. The rest of 125 patients were followed for a mean of 27 months (range, 1~43 months), and survived without renal fossa or incision metastasis, or distant recurrence.ConclusionsRetroperitoneal laparoscopic radical nephrectomy is a safe, reliable, and effective technique for renal tumors.

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更新日期/Last Update: 2013-11-15