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目的探讨后腹腔镜下解剖性根治性肾切除术的安全性和临床疗效。方法自2013-01-2015-07山东省单县中心医院行后腹腔镜下解剖性根治性肾切除术56例。本组患者年龄49~75岁,男42例,女14例,平均年龄(55.3±12.6)岁,体质量指数(21.32±1.57)kg/m2,肿瘤直径4.5~12.5cm,平均8.5cm,左侧26例,右侧30例,肿瘤分期T1N0M034例,T2N0M022例。分析手术时间,术中出血量,术后住院天数,并发症等指标。结果 56例手术均获得成功。手术平均时间为77.5min(35~120min);平均出血量25mL(15~35mL);平均术后住院天数6d(5~10d)。所有患者无明显手术并发症。结论经后腹腔镜解剖性根治性肾切除术在肾周的无血管层面分离,具有解剖标志明确,术野清晰,手术时间短,出血少,住院时间短,并发症少,学习曲线短等优点,是一种能够快速掌握后腹腔镜根治性肾切除术安全有效的方法。
Objective To investigate the safety and clinical efficacy of retroperitoneoscopic anatomic radical nephrectomy. Methods From January 2013 to July 2015, 56 patients underwent laparoscopic anatomic radical nephrectomy at Shanxian Central Hospital of Shandong Province. The age ranged from 49 to 75 years old, there were 42 males and 14 females, with an average age of (55.3 ± 12.6) years, body mass index (21.32 ± 1.57) kg / m2 and tumor diameter of 4.5-12.5 cm 26 cases in the right side, 30 cases in the right side, T1N0M034 cases and T2N0M022 cases. Analysis of operation time, intraoperative blood loss, postoperative hospital days, complications and other indicators. Results 56 cases of surgery were successful. The average operation time was 77.5min (35 ~ 120min). The average amount of bleeding was 25mL (15 ~ 35mL). The average postoperative hospital stay was 6d (5-10d). All patients had no obvious complications of surgery. Conclusions The retroperitoneal laparoscopic anatomic radical nephrectomy is performed in the avascular area of the perirenal region and has the advantages of clear anatomy, clear operative field, short operative time, less bleeding, shorter hospital stay, fewer complications and shorter learning curve , Is a safe and effective way to quickly master the retroperitoneal radical nephrectomy.