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目的 :探讨后腹腔镜泌尿外科手术致后腹膜腔感染的原因及防治措施。方法 :对 2 0 0 1~ 2 0 0 3年开展的共71例后腹腔镜泌尿外科手术 ,采用曲卡直接穿刺法建立后腹膜腔气腹 ,肾囊肿去顶减压术 50例、肾上腺肿瘤切除术 2 0例、肾切除术 1例 ;共发生后腹膜腔感染 2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 70例手术均获成功 ,手术时间肾囊肿 3 0~ 12 0min ,肾上腺 45~ 14 0min ,1例肾切除2 10min ;失血量 2 0~ 10 0ml,平均 50ml;有 2例并发后腹膜腔感染 ,经积极抗感染开充分引流后痊愈。结论 :熟练操作技术 ,术中仔细止血 ,减少已切除脂肪存留体内和保障术后引流管通畅是减少术后感染的主要方法
Objective: To investigate the causes and prevention measures of retroperitoneal cavity infection caused by retroperitoneal laparoscopic urological surgery. Methods: A total of 71 cases of retroperitoneal laparoscopic urological surgery performed in 2001-2003 were retrospectively established. The retroperitoneal pneumoperitoneum, peritoneal cavity decompression, and adrenal tumor 20 cases underwent resection and 1 case underwent nephrectomy. There were 2 cases of retroperitoneal infection. Results: All the other 70 cases were successful except one case of renal cyst debridement and decompression because of failure of retroperitoneal cavity preparation. The operation time was 30 ~ 120 min, adrenal 45 ~ 140 min, 1 case of kidney 2 10min after resection; blood loss 20 ~ 10 0ml, an average of 50ml; 2 cases of retroperitoneal infection, positive anti-infection open full recovery. Conclusions: Skilled operation technique, careful operation of hemostasis, reduction of fat removal body and protection of postoperative drainage tube are the main methods to reduce postoperative infection