[1]魏世平 刘巍 李晓山**.45°一站式斜仰卧位腹腔镜上尿路上皮癌根治术[J].中国微创外科杂志,2022,01(6):510-513.
　Wei Shiping,Liu Wei,Li Xiaoshan..45° Onestop Oblique Supine Position Laparoscopic Radical Resection of Upper Tract Urothelial Carcinoma[J].Chinese Journal of Minimally Invasive Surgery,2022,01(6):510-513.
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45°一站式斜仰卧位腹腔镜上尿路上皮癌根治术()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2022年6期
页码:
510-513
栏目:
经验交流
出版日期:
2022-10-11

文章信息/Info

Title:
45° Onestop Oblique Supine Position Laparoscopic Radical Resection of Upper Tract Urothelial Carcinoma
作者:
魏世平 刘巍 李晓山**
(长江航运总医院泌尿外科，武汉430010)
Author(s):
Wei Shiping;  Liu Wei;  Li Xiaoshan.
Department of Urology, General Hospital of the Yangtze River Shipping, Wuhan 430010, China
关键词:
上尿路上皮癌; 腹腔镜; 斜仰卧位
Keywords:
Upper tract urothelial carcinoma; Laparoscope; Oblique supine position
文献标志码:
B
摘要:
目的探讨45°一站式斜仰卧位腹腔镜上尿路上皮癌根治术治疗上尿路尿路上皮癌(upper tract urothelial carcinoma，UTUC)的安全性和有效性。方法2019年8月~2020年7月我院采用45°一站式斜仰卧位经腹腔途径腹腔镜上尿路上皮癌根治术治疗12例上尿路上皮癌。患侧与手术台水平面成45°斜仰卧位，脐水平腹正中线向患侧旁4 cm取1 cm切口置入10 mm trocar，建立CO2气腹，以此孔作为观察孔(A)置入腹腔镜，直视下分别建立另外3个操作孔(B、C、D)和1个辅助孔(E)，其中B孔位于A孔垂直向上4 cm处，C孔水平向外侧4 cm处，D孔为A孔下内侧2 cm。30°腹腔镜探查腹腔，以A孔为观察孔，B、C孔为操作孔，完整游离肾及上段输尿管。腹腔镜监视器转移至患者足端，以A孔为观察孔，C、D孔为操作孔分离并完整切除输尿管下段和膀胱壁内段。在整个手术过程中，E孔为辅助暴露术野。结果12例均一期完成手术，手术时间65~90 min，平均75 min；出血量30~100 ml，平均50 ml；无输血、肠管、内脏器官副损伤并发症，无腹腔内及切口感染。11例术后随访12个月，无术后种植转移。结论45°一站式斜仰卧位腹腔镜UTUC根治术治疗UTUC是安全可行的。
Abstract:
ObjectiveTo investigate the safety and efficacy of 45° onestop oblique supine position laparoscopic radical resection of upper tract urothelial carcinoma(UTUC).MethodsFrom August 2019 to July 2020, 12 cases of UTUC were treated with laparoscopic radical resection under 45° onestop oblique supine position via abdominal approach in our hospital. The affected side was placed in a 45 ° oblique supine position with the horizontal plane of the operating table. A 1 cm incision was taken at 4 cm from the midline of the umbilicus to the affected side and a 10 mm trocar was inserted to establish CO2 pneumoperitoneum. This hole was used as the observation hole (A) through which the laparoscope was placed into. Under direct vision, another 3 operation holes (B, C, D) and 1 auxiliary hole (E) were established, where the hole B was located at 4 cm vertically upward of the hole A, the hole C was 4 cm horizontally outward, and the hole D was 2 cm below the inner side of the hole A. The abdominal cavity was explored by a 30° laparoscope. With the hole A as the observation hole, the hole B and hole C as the operation holes, the kidney and upper ureter were completely resected. Then the laparoscopic monitor was transferred to the footside of the patient, and the hole A was used as the observation hole and the holes C and D were used as the operation holes to separate the lower ureter segment and the inner bladder wall segment completely. During the whole operation, the hole E was used as the auxiliary exposure field.ResultsThe operations in all the 12 patients were completed in one stage. The operation time was 65-90 min (mean, 75 min). The blood loss was 30-100 ml (mean, 50 ml). There were no need for blood transfusion or complications of intestinal and visceral injury. All the patients were followed up for 12 months without postoperative implantation metastasis. ConclusionThe 45° onestop oblique supine position laparoscopic radical resection of UTUC is safe and feasible.

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备注/Memo

备注/Memo:
基金项目：武汉市卫健委科研项目（WX21D65）**通讯作者，Email：1263362910@qq.com
更新日期/Last Update: 2022-10-11