摘要
目的 :评价用曲卡直接穿刺法建立腹膜后腔气腹 ,行腹腔镜肾上腺肿瘤切除术及肾脏手术的临床价值 .方法 :对 2 0 0 2年 3月以来开展的 6 4例后腹腔镜泌尿系手术进行分析 .本组患者全部采用曲卡直接穿刺法建立后腹膜腔气腹 ,用后腹腔镜技术完成所有病例 ,其中肾囊肿去顶减压术 4 5例、肾上腺肿瘤切除术 18例、肾切除术 1例 .结果 :除 1例肾囊肿去顶减压术因后腹膜腔制备失败改行开放手术外 ,其余 6 3例手术均获成功 ,手术时间 :肾囊肿 30～ 12 0min ,肾上腺 70～ 14 0min ,1例肾切除 2 10min ;失血量 2 0～ 10 0mL ,平均 5 0mL ,术中及术后均未输血 ,全部患者均无并发症 .结论 :曲卡直接穿刺法建立后腹膜腔行腹腔镜肾脏及肾上腺手术具有创伤小、进路直接、易于掌握、几乎无皮下气肿发生、出血少、对腹腔干扰小、术后恢复快等优点 。
Objective: Posterior retroperitoneoscopy is a new minimally invasive technique for urologic diseases. We present our 64 cases using this anatomical route for laparoscopic surgery. Methods: After trocar insertion we used a balloon dilator to create a retroperitoneal space, then prepared the pneumoretroperitoneum. Since March 2002, retroperitoneal laparoscopy has been applied to 64 cases, of which 45 renal cysts, 18 adrenal tumors and 1 renalectomy. Results: The procedure was successful in the 63/64 cases, the operation time was 30～120 minutes for renal cystic diseases, 70～140 minutes for adrenal tumors and 210 minutes for renalectomy; there was no need for blood transfusion with the blood loss range from 20?mL to 100?mL; no complication occurred during operation or postoperatively. Conclusions: Creation of a pneumoretroperitoneum after the direct application of trocar insertion for retroperitoneal laparoscopy is proved to be a procedure with microinvasive, safety, less bleeding, postoperative immediate recovery and less complications. It could be the first choice for most adrenal adenoma and some renal diseases.
出处
《昆明医学院学报》
2003年第3期89-91,共3页
Journal of Kunming Medical College
