【摘要】 目的:探讨应用单孔腹腔镜手术(LESS)治疗泌尿系肿瘤的临床安全性及可行性。方法:2009年10月~2012年8月,应用单孔4通道技术治疗7例前列腺癌,4例肾肿瘤,1例肾盂癌,1例输尿管癌,12例肾上腺肿瘤和囊肿。根治性前列腺切除术采用经脐切口腹膜外途径或经腹腔途径,肾切除术和肾输尿管切除术采用经脐腹腔途径,肾上腺切除术采用经后腹膜腔途径。记录手术时间、估计术中出血量、术中并发症、留置引流管时间、术后疼痛情况(VAPS)和术后住院时间,并对结果进行分析。结果:25例手术均由LESS完成,未加辅助通道,无转标准腹腔镜或开放手术。根治性前列腺切除术、肾切除术和肾输尿管切除术、肾上腺切除术平均手术操作时间分别为259.3(190~305)min、203.3(120~255)min、91.7(35~185)min。术后第1天平均VAPS为1.2(0~3)分、1.3(0~2)分、1.8(1~3)分。本组手术无术中严重并发症,无术后继发性出血和切口感染病例。本组恶性肿瘤标本外科切缘均阴性。结论:LESS治疗泌尿系肿瘤是安全和可行的手术选择。更多还原

【Abstract】 Objective:To verify the safety and feasibility of applying laparoendoscopic single-site surgery(LESS)in the treatment of urological tumors.Methods:From Oct 2009 to Aug 2012,we used LESS surgery technique to treat seven prostate cancer cases,four kidney tumor cases(one right,three left),one left renal pelvic cancer case,one left ureteral cancer case and 12 adrenal tumor and cyst cases.The radical prostatectomy was preformed through extra-peritoneal approach in first six cases and trans-peritoneal approach in 7th case,nephrectomy and nephreoureterectomy were performed through trans-peritoneal approach and adrenalectomy was performed through retroperitoneal approach.We evaluated this technique in respects of operative time,estimated blood loss,intraoperative complications,first post-operative day Visual Analog Pain Scale(VAPS)and post-operative hospital stay.Results:All procedures of the 25 cases in this group were completed with pure LESS without additional assistant trocar or conversion to standard laparoscopic surgery or open surgery.The average operative time for LESS radical prostatectomy,nephrectomy and nephroureterectomy,adrenalectomy were 259.3(190-305)min,203.3(120-255)min and 91.7(35-185)min respectively.The VAPS in the first post-operative day were 1.2(0-3)d,1.3(0-2)d and 1.8(1-3)d.There was no severe intraoperative complication.There was no secondary bleeding or wound infection.All the malignant specimens in this group were negative in surgical margin.Conclusions:LESS is a safe and feasible option for the treatment of urological tumors.更多还原