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目的评价后腹腔镜联合下腹部小切口途径治疗输尿管癌的手术疗效。方法经后腹腔镜联合下腹部小切口行输尿管癌根治术24例。采用腰部3个穿刺套管针入路,在后腹腔镜下行根治性肾切除,输尿管尽量向下游离;然后下腹部做5～8cm切口,行下段输尿管及部分膀胱袖状切除,取出肾输尿管组织标本。结果所有手术均取得成功。平均手术时间为(150.5±45.5)min,术中平均出血量(180±42.5)ml,术后平均住院时间为(9±2.5)d。围手术期无明显并发症。20例术后随诊1～24个月,1例因其他疾病死亡,3例发生膀胱肿瘤,后行膀胱肿瘤电切术。结论后腹腔镜联合下腹部小切口行输尿管癌根治术治疗是一种安全有效的微创方法。
Objective To evaluate the effect of retroperitoneal laparoscopy combined with small incision in lower abdomen to treat ureteral carcinoma. Methods Retroperitoneal laparoscopic combined with a small incision in the lower abdomen underwent radical ureteral cancer in 24 cases. Using the three puncture trocar waist approach laparoscopic radical nephrectomy, the ureter as far as possible free; then the lower abdomen to do 5 ~ 8cm incision line lower ureter and some bladder sleeve resection, remove the renal ureter tissue specimen. Results All operations were successful. The average operation time was (150.5 ± 45.5) min, mean intraoperative blood loss was (180 ± 42.5) ml and the average postoperative hospital stay was (9 ± 2.5) days. Perioperative no significant complications. Twenty patients were followed up for 1 to 24 months, 1 died of other diseases, 3 had bladder tumor, and underwent resection of bladder tumor. Conclusions Retroperitoneal laparoscopy combined with small incision of the lower abdomen underwent radical ureteral cancer radical surgery is a safe and effective minimally invasive method.