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目的:研究肾周腹膜后腔的解剖特点,探讨经后腹腔镜进行肾癌根治性切除术的手术入路。方法:采用后腹腔镜技术对82名肾癌患者行肾癌根治性切除术,通过术中观察、手术录像及总结既往经验,分析肾周解剖结构的特点、相互关系,以寻找更加安全、可靠、快捷的手术路径。结果:82例手术顺利,手术平均时间120.32min,平均出血量70.32 ml,术中及术后未出现严重并发症,48例获7～77个月随访,1例术后34个月局部复发,术后4年死于转移性肾癌。结论:利用肾周腹膜后腔的解剖特点,合理选择手术入路,可以减少出血,缩短手术时间,并且减少术后并发症的发生,提高疗效。
Objective: To study the anatomic characteristics of perirenal peritoneal cavity and to explore the surgical approach of radical retroperitoneal laparoscopic resection of renal cell carcinoma. Methods: Retroperitoneoscopic laparoscopic radical nephrectomy was performed on 82 patients with renal cell carcinoma. Through the intraoperative observation, video recording and past experience, the characteristics and correlations of the renal peritoneal anatomy were analyzed to find out more safe and reliable , Quick surgical path. Results: The operation was successful in 82 cases. The average operation time was 120.32 minutes and the average bleeding volume was 70.32 ml. There were no serious complications during and after operation. 48 cases were followed up for 7 to 77 months. One case had local recurrence 34 months after operation, 4 years after the death of metastatic renal cell carcinoma. Conclusion: The peritoneal cavity of the perirenal anatomical features of the rational choice of surgical approach, can reduce bleeding, shorten the operation time, and reduce the incidence of postoperative complications and improve efficacy.