【摘要】 目的 评价后腹腔镜肾癌根治性切除术改进后的临床效果。 方法 回顾性分阶段比较后腹腔镜肾癌根治性切除术的30例病例,探讨了后腹腔镜肾癌根治术的手术技巧和改进,比较其术中出血量及手术时间及术后恢复情况,并对病例进行随访。 结果 随著技术改进和成熟,手术时间和术中出血量明显减少,平均手术时间101±41.4 min,由最初5例平均166 min减少到最后5例平均74 min,平均术中出血量51±44 ml,由最初5例平均104 ml减少到最后5例平均26 ml。术后肠功能恢复时间平均32±18hrs、术后下床活动时间30.4±12hrs、术后住院天数5.6±1.5 d,术中及术后未发生无明显并发症,随访2～20月未见肿瘤复发与穿刺通道的种植性转移。 结论 与传统的腹腔镜根治性肾切除术相比,改进后的后腹腔镜根治性肾切除具有手术时间短,出血少,并发症少的优点。更多还原

【Abstract】 Objective: To evaluate the clinical efficacy of the modified retroperitoneal laparoscopic radical nephrectomy. Methods: Thirty cases who had received retroperitoneal laparoscopic radical nephrectomy (RLRN) were retrospectively compared in terms of blood loss, operative time and followed up. Results: The modified retroperitoneal laparoscopic radical nephrectomy could substantially shorten operation time and reduce blood loss and result in no obvious complications. The mean operative time was 101±41.4 min, with the mean time of 166 min being in initial 5 cases being reduced to 74 min in the final 5 cases. The mean operative blood loss was 51±44 ml, with the mean blood loss of 104 ml in the initial 5 cases being reduced to 26 ml in the final 5 cases. The postoperative bowl function recovery time was 32±18 h on average; the operative ambulatory time was 30.4±12 h; postoperative hospital stay was 5.6±1.5 days. The follow-up study revealed no local relapse of tumor and implantation metastasis of puncture channel. Conclusion: Compared with traditional retroperitoneal laparoscopic radical nephrectomy, the modified technique has the merits of shorten operation time, reduced blood loss and less complications.更多还原