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目的:探讨经腹腹腔镜半肾切除术治疗成人重复肾畸形的方法、可行性和临床疗效。方法:回顾我院2010年6月~2014年1月采用经腹腹腔镜行重复肾畸形上半肾切除术治疗12例患者,其中男4例,女8例,年龄18~56岁,平均36岁。左侧9例,右侧3例,12例重复肾畸形患者均为上半肾病变。结果:12例手术均获成功,无中转开放手术。手术时间60~120min,平均90min;术中出血量20~150ml,平均50ml;术后肠道功能恢复时间1~3d,平均2d;术后24~72h进流食,3~4d拔除引流管;术后住院时间7~9d,平均8d;术后随诊6~15个月,平均9个月;术后3、6个月内均行IVU检查,下半肾功能均正常,原发症状消失。结论:经腹腹腔镜半肾切除术治疗成人重复肾畸形具有手术视野开阔、住院时间短、创伤小、恢复快等优点,是治疗成人重复肾畸形安全有效的手术方法。
Objective: To investigate the method, feasibility and clinical efficacy of trans laparoscopic radical nephrectomy for the treatment of adult renal abnormalities. Methods: A retrospective study from June 2010 to January 2014 in our hospital with laparoscopic retroperitoneal nephrectomy for the treatment of 12 patients, including 4 males and 8 females, aged 18 to 56 years, an average of 36 year old. 9 cases on the left, 3 cases on the right, and 12 cases of patients with repeated nephrons were all upper nephropathy. Results: All the 12 surgeries were successful. There was no transfer surgery. The operation time was 60 ~ 120min with an average of 90min. The intraoperative blood loss was 20 ~ 150ml with an average of 50ml. The postoperative recovery time of intestinal function was 1 ~ 3d with an average of 2 days. After 24 ~ 72h, The hospitalization time ranged from 7 days to 9 days, with an average of 8 days. The patients were followed up for 6 to 15 months with an average of 9 months. IVU examination was performed within 3 and 6 months after operation. The function of the lower half of the kidney was normal and the primary symptoms disappeared. Conclusion: Laparoscopic nephrectomy for the treatment of adult patients with recurrent renal deformity has the advantages of open field of vision, shorter hospital stay, less trauma and faster recovery. It is a safe and effective surgical treatment of adult renal abnormalities.