[1]赵磊,马潞林,侯小飞,等.Hem-o-lok在后腹腔镜肾切除术中的应用[J].中国微创外科杂志,2007,07(8):743-744.
　Zhao Lei,Ma Lulin,Hou Xiaofei,et al.Application of the Hemolok in Retroperitoneal Laparoscopic Nephrectomy[J].Chinese Journal of Minimally Invasive Surgery,2007,07(8):743-744.
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Hem-o-lok在后腹腔镜肾切除术中的应用()
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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8期
页码:
743-744
栏目:
出版日期:
2007-08-20

文章信息/Info

Title:
Application of the Hemolok in Retroperitoneal Laparoscopic Nephrectomy
作者:
赵磊; 马潞林; 侯小飞; 张树栋; 张荣新
北京大学第三医院泌尿外科，北京100083
Author(s):
Zhao Lei;  Ma Lulin;  Hou Xiaofei;  et al.
Department of Urology, Peking University Third Hospital, Beijing 100083, China
关键词:
腹腔镜; 肾切除术; Hemolok
Keywords:
Laparoscopy; Nephrectomy; Hemolok
分类号:
R699.2
文献标志码:
A
摘要:
目的探讨后腹腔镜下肾切除术中带锁塑料夹（Hemolok）的应用效果。方法2003年11月～2006年11月行后腹腔镜下肾切除术178例。取腰部3个穿刺点入路，肾动脉和静脉分别用Hemolok夹闭后切断，输尿管在近髂血管处切断。对于活体取肾，立即取出肾脏用4 ℃肾脏保存液灌注肾脏。结果178例手术均成功，无中转开放手术，无Hemolok滑脱。手术时间平均100 min（60～200 min），术中出血量平均95 ml（20～200 ml）。并发症2例：肾静脉损伤1例，胰尾损伤1例。术后住院平均5 d（4～8 d）。病理报告：65例肾透明细胞癌，肾囊腺癌3例，平滑肌肉瘤1例，肾淋巴瘤1例，肾嗜酸细胞瘤2例，肾错构瘤2例；输尿管移行细胞癌12例，输尿管鳞癌2例；肾盂移行细胞癌31例，肾盂黄色肉芽肿1例；肾结核4例，副肾1例，肾结石4例，肾积水4例，肾脓肿1例。136例随访1~36个月，平均25个月，64例随访<1年，53例随访1～2年，19例随访2～3年，未发现肾窝及切口转移，未发现远处转移。结论后腹腔镜下肾切除术中使用Hemolok处理肾脏血管安全可靠，疗效良好，对于活体取肾保证供肾血管长度有优势。
Abstract:
ObjectiveTo evaluate the safety and effectiveness of the Hemolok in retroperitoneal laparoscopic nephrectomy.MethodsA total of 178 patients underwent retroperitoneal laparoscopic nephrectomy from November 2003 to November 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 cut at the site near the iliac blood vessel. For living donor nephrectomy, the kidney was taken out and infused with 4℃ kidney preserving fluid immediately.ResultsThe operation was successfully completed in all the 178 cases and there was no conversion to open surgery. No Hemolok ligating clips became dislodged. The mean operation time was 100 min (60-200 min), and the mean blood loss was 95 ml (20-200 ml). Complications included renal vein injury in 1 patient and pancreatic tail injury in 1 patient. The mean length of postoperative hospital stay was 5 days (4-8 days). Pathological results showed renal clear cell carcinoma in 65 patients, renal cystadenocarcinoma in 3 patients, renal leiomyosarcoma in 1 patient, renal lymphoma in 1 patient, renal oncocytoma in 2 patients, renal hamartoma in 2 patients, ureteral transitional cell carcinoma in 12 patients, ureteral squamous cell carcinoma in 2 patients, renal pelvis transitional cell carcinoma in 31 patients, renal pelvis xanthogranuloma in 1 patient, renal tuberculosis in 4 patients, accessory kidney in 1 patient, renal calculus in 4 patients, nephrohydrosis in 4 patients, and renal abscess in 1 patient. A total of 136 patients were followed for 1-36 months (mean, 25 months), involving 64 patients followed for < 1 year, 53 patients for 1-2 years, and 19 patients for 2-3 years. No metastasis (kidney bed, port site, or distant organs) was found.ConclusionsThe Hemolok can be used safely and reliably in retroperitoneal laparoscopic nephrectomy, especially in living donor nephrectomy requiring long donor blood vessels.

参考文献/References:

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更新日期/Last Update: 2013-12-09