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目的:探讨经腹腹腔镜技术行肾、输尿管全长切除在肾盂输尿管癌根治术中的应用价值。方法:52例肾盂癌、输尿管癌患者应用经腹腹腔镜技术行肾、输尿管全长切除术。手术采用健侧卧位70°,采用腹部3孔或4孔法先行根治性切除肾脏,更换器械操作通道,向下完全分离全长输尿管及输尿管膀胱壁段,全长切除输尿管后缝合膀胱切口。结果:手术均获成功,无中转开放病例,手术时间90～165min,平均(113.4±18.2)min,术中出血量30～200ml,平均(69.2±27.3)ml,无尿漏及其他并发症发生,术后1周拔出尿管。结论:经腹腹腔镜肾、输尿管全长切除术具有视野好、空间大,出血少,术中无需转换体位及再行切口,创伤小,是治疗肾盂癌、输尿管癌的较好选择,具有推广应用价值。
Objective: To investigate the value of transabdominal laparoscopy in the treatment of radical ureteropelvic cancer with total removal of the kidney and ureter. Methods: 52 patients with renal pelvic cancer and ureteral cancer underwent laparoscopic transabdominal surgery for total kidney and ureter resection. Surgical use of the healthy lateral position 70 °, the use of abdominal 3-hole or 4-hole method of radical resection of the kidney, the replacement of equipment operating channel, the full separation of the full length of the ureter and ureter wall segment, the total length of the ureter after resection of the bladder incision. Results: The operation was successful without any intervention. The operation time ranged from 90 to 165 minutes, with an average of (113.4 ± 18.2) min. The blood loss was 30 ~ 200ml, with an average of 69.2 ± 27.3ml. There was no urinary leakage and other complications , Pull out the catheter after 1 week. Conclusion: Transabdominal laparoscopic radical nephroureterectomy has the advantages of good field of vision, large space, less bleeding, no need to change position and re-incision in operation, small trauma, is a good choice for the treatment of renal pelvis cancer and ureteral cancer, with the promotion Value.