【摘要】 目的探讨经腹途径腹腔镜根治性肾切除术治疗肾癌的临床效果及休会。方法2000年10月～2009年8月共收治肾癌85例,男性47例,女性38例,年龄30～80岁(平均57岁),肾上极有25例,肾中极有36例,肾下极有24例;肿瘤平均直径4.8cm,左侧46例,右侧39例,75例肿瘤直径小于8cm,采用经腹腹腔镜肾癌根治术。10例肿瘤直径大于10cm,采用手辅式腹腔镜肾癌根治术。结果84例腹腔镜肾癌根治手术成功,1例右肾动脉损伤改开放手术,3例胰腺损伤,1月后治愈;手术时间85～360min,平均145min。术中出血量约60～430ml之间,平均125ml。4例穿刺口周围不同程度皮下气肿,3d后自行消失。术后24h下床活动,48h开始进食,术后7d出院。50例随访6～0.5年,无肿瘤复发,无穿刺孔种植转移。结论腹腔镜肾癌根治术具有术中创伤小,术后恢复快,疼痛小的优点,对于T1～T2N0M0期肾肿瘤,效果优于开放手术;是一种安全,有效的治疗方法。更多还原

【Abstract】 Objective To evaluate the clinical value and reported our experiences with transabdominal laparoscopic radical nephrectomy in the treatment of patients with renal carcinoma.Methods 85 cases of renal carcinoma were admitted to our departmentduring October 2000 to November 2009.Of these cases,there were 47 males and 38 females whose ages ranging from 30-80 years old (mean age 57years).46 cases had left-sided diseases and 39 had right.75 cases who had tumors less than 8 cm in diameter were treated by transabdominal laparoscopic radical nephrectomy.10 cases who had tumors more than 8 cm in diameter were treated by hand-assisted transperitoneoscopic radical nephrectomy.Results In 84 of 85cases,nephrectomies were undergone successfully by laparoscopic procedure.In 1 case,the procedure was needed conversion to open surgery because of uncontrollable bleeding from injury to the right renal artery,In 1case,injury of pancreas,cure after one month 。Operativetime ranged from85 ～360min (mean operative time 145min).Intraoperative blood losses were about 60 ～430 ml (mean blood loss 125 ml).Subcutaneous emphysema around the ports sites in 3 cases spontaneously disappeared 3days post operation.The patients resumed activity 24 hours,began oral intake 48 hours and discharged 7 days post operation.No local lesion and port sites metastasis in 50 cases of these patients occurred in 6 ～0.5 years follow-up.Conclusion As compared to open radical nephrectomy,laparoscopic radical nephrectomy has the advantages of rapid recovery and less pain.Laparoscopic radical nephrectomy needs a higher skill,but was superior to open nephrectomy for renal tumor of T1 ～T2bN0M0.was a safe,effective and efficient surgical procedure.更多还原