论文部分内容阅读
目的:报告经后腹腔途经腹腔镜下肾癌根治术的临床效果。方法:肾癌患者247例术前均行B超、CT、KUB加IVU和(或)逆行造影确诊。右肾癌148例,左肾癌99例。TNM分期:T_1N_0M_0 188例,T_2N_0M_0 59例。均行经腹或后腹腔径路腹腔镜下肾癌根治术。观察手术时间、术中出血量、术后引流量、肠功能恢复时间和术后住院时间。结果:所有手术顺利完成,手术时间80～150min,平均120min。术中出血量100～300ml,平均200ml。术后引流量100～300ml,平均200ml。3～5天拔引流管。术后肠功能恢复时间,经腹途经2～3天,后腹腔径路1～2天。术后住院时间7～9天,平均8天。经腹和后腹腔径路无明显差异。术后病理报告均为透明细胞癌。随访3～36个月,平均15个月;未见肿瘤复发及转移。结论:经腹或后腹腔径路腹腔镜下肾癌根治术,对患者干扰少、创伤小、术后恢复快,明显优于开放手术。经腹途经视野好,后腹腔径路可能对腹腔无干扰。
Objective: To report the clinical effect of laparoscopic radical nephrectomy via retroperitoneal approach. Methods: Twenty-four patients with renal cell carcinoma underwent preoperative B-ultrasound, CT, KUB plus IVU and / or retrograde angiography. 148 cases of right kidney cancer, 99 cases of left kidney cancer. TNM stage: T_1N_0M_0 188 cases, T_2N_0M_0 59 cases. Laparoscopic or retroperitoneal laparoscopic radical nephrectomy were performed. The operation time, intraoperative blood loss, postoperative drainage, intestinal function recovery time and postoperative hospital stay were observed. Results: All the operations were successfully completed. The operation time was 80-150 minutes with an average of 120 minutes. Intraoperative blood loss of 100 ~ 300ml, an average of 200ml. Postoperative drainage 100 ~ 300ml, an average of 200ml. 3 to 5 days to pull the drainage tube. Intestinal function recovery time after transabdominal transit by 2 to 3 days, 1 to 2 days after the abdominal path. Postoperative hospital stay 7 to 9 days, an average of 8 days. Abdominal and retroperitoneal pathways no significant difference. Postoperative pathological reports were clear cell carcinoma. Followed up for 3 to 36 months, an average of 15 months; no tumor recurrence and metastasis. CONCLUSION: Laparoscopic radical nephrectomy with transabdominal or retroperitoneal laparoscopic approach has less interference, less trauma and faster recovery than patients undergoing open surgery. Transverse via visual field, posterior abdominal path may not interfere with the abdominal cavity.