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目的:探讨后腹腔镜肾切除的方法及效果。方法:回顾性分析45例后腹腔镜肾切除术的临床资料,其中单纯性肾切除术36例,肾癌根治术9例。结果:45例中42例手术成功,3例转为开放手术,手术时间平均134 min;术中出血量平均78 ml;术后平均住院天数8.2天。9例肾癌患者中,2例于术前CT增强发现异位动脉,并于术中依照CT所示部位顺利予以结扎。术后随访1～7个月,1例肾癌患者因对侧肾功能不佳而行透析治疗。结论:后腹腔镜肾切除术出血少、效果好、患者恢复快等特点,术前行CT增强扫描有助于术中判断肾血管位置。
Objective: To investigate the method and effect of retroperitoneal nephrectomy. Methods: A retrospective analysis of 45 cases of retroperitoneal nephrectomy clinical data, including simple nephrectomy in 36 cases, radical nephrectomy in 9 cases. Results: Of the 45 cases, 42 cases were successfully operated and 3 cases switched to open surgery. The average operation time was 134 minutes. The average amount of blood loss during operation was 78 ml. The average postoperative hospital stay was 8.2 days. In 9 cases of renal cell carcinoma, 2 cases showed enhancement of the ectopic artery by preoperative CT, and ligation was successfully performed during the operation according to the CT site. Follow-up 1 to 7 months after surgery, 1 case of renal cell carcinoma due to poor renal function and dialysis treatment. Conclusions: The retroperitoneal laparoscopic nephrectomy has the advantages of less bleeding, better effect and faster recovery of patients. Preoperative CT enhanced scan is helpful to determine the position of renal artery during operation.