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目的评价腹腔镜术治疗泌尿外科疾病的疗效、安全性,并总结治疗体会。方法应用腹腔镜(经腹腔或腹膜后或腹膜外途径)进行肾囊肿去顶术160例,肾肿瘤根治术2例,单纯肾切除术15例,重复肾输尿管切除术2例,肾盂肿瘤根治术6例,输尿管肿瘤根治术1例,肾上腺肿瘤或肾上腺切除术57例,输尿管切开取石术25例,肾盂-输尿管成形术、肾蒂淋巴管结扎术各1例,前列腺癌根治术4例,精索内静脉高位结扎术11例,腹腔内双侧隐睾下降固定术1例。结果肾囊肿去顶术160例中,成功156例,手术时间30￣185 min,平均82 min;4例中转开腹,均为后腹腔途径。肾肿瘤根治术2例均获成功,手术时间145￣160 min。肾切除术组17例均获成功,手术时间85￣220 min。肾盂或输尿管肿瘤根治术7例均成功,手术时间210￣310 min。肾上腺肿瘤组56例成功,首例中转开放手术。手术时间45￣225 min,平均132 min。输尿管切开取石术25例均获成功,手术时间105￣180 min,平均124min。肾盂-输尿管成形术、肾蒂淋巴管结扎术、前列腺癌根治术、精索内静脉高位结扎术及腹腔内隐睾下降固定术也均获得成功。术后恢复顺利,术后住院2￣23 d,平均5.3 d。结论腹腔镜术治疗泌尿外科疾病,手术安全、有效、创伤小,患者痛苦轻,术后恢复快。
Objective To evaluate the efficacy and safety of laparoscopic surgery for urological diseases and to summarize the experience of treatment. Methods Laparoscopy (peritoneal or retroperitoneal or extraperitoneal route) was performed in 160 cases of renal cyst debridement, 2 cases of radical nephrectomy, 15 cases of simple nephrectomy, 2 cases of repeated nephroureterectomy, radical nephroureterectomy 6 cases, radical ureter tumor in 1 case, adrenal tumor or adrenalectomy in 57 cases, ureterolithotomy in 25 cases, renal pelvis - ureteroplasty, renal pedicle lymphatic ligation in 1 case, radical prostatectomy in 4 cases, Eleven cases of spermatic vein ligation, lumbar bilateral cryptorchidism decreased fixation in 1 case. Results Among the 160 cases of renal cyst debridement, 156 cases were successful, the operation time was 30 to 185 minutes (average 82 minutes), and 4 cases were converted to the laparotomy. Radical nephrectomy in 2 cases were successful, the operation time was 145 ~ 160 min. Nephrectomy group of 17 patients were successful, operation time 85 ~ 220 min. 7 cases of renal pelvis or ureter tumor radical operation were successful, the operation time was 210 ~ 310 min. 56 cases of adrenal tumor success, the first case of open surgery. Operative time 45 ~ 225 min, an average of 132 min. Ureterolithotomy in 25 cases were successful, the operative time 105 ~ 180 min, an average of 124min. Renal pelvis-ureteroplasty, renal pedicle lymphatic ligation, radical prostatectomy, spermatic vein ligation and intra-abdominal cryptorchidism were also successful. Postoperative recovery was good, postoperative hospital stay 2 ~ 23 d, an average of 5.3 d. Conclusion Laparoscopic surgery for urological diseases, surgical safety, effective, less trauma, patients with mild pain, rapid recovery after surgery.