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目的探讨后腹腔镜联合下腹部小切口在肾盂癌根治术中的应用。方法 2005年10月至2010年3月应用后腹腔联合下腹部小切口的方法对19例T1、T2肾盂癌进行根治性切除。手术采用腰部3孔或4孔法切除肾脏并完成输尿管的全段游离,由下腹部5～6cm小切口取出肾脏,直视下袖状切除输尿管壁间段,缝合膀胱切口。结果手术均获成功,无中转开放病例,手术时间110～210min,平均145min,术中平均出血80ml,无尿瘘及其他并发症发生,术后1周拔出尿管。结论后腹腔镜联合下腹小切口进行的肾盂癌根治术,具有出血少、无尿瘘发生、并发症少,手术易掌握、学习曲线短等优点,它是微创方法治疗肾盂癌的较好选择,具有推广应用价值。
Objective To investigate the application of retroperitoneal laparoscopic combined with abdominal incision in radical nephrectomy. Methods From October 2005 to March 2010, 19 cases of T1 and T2 renal pelvic cancer were treated by retroperitoneal abdominal incision. Surgical use of 3 or 4 waist hole removal of the kidneys and the complete removal of the entire ureter, from the lower abdomen 5 ~ 6cm small incision out of the kidney, under direct vision sleeve sleeve removal of the ureteral wall, the suture of the bladder incision. Results All the operations were successful. There were no cases of transfer and open surgery. The operation time was 110 ~ 210min with an average of 145min. The mean intraoperative bleeding was 80ml. No urinary fistula and other complications occurred. The catheter was pulled out one week after operation. Conclusions Retroperitoneal laparoscopic radical nephroureterectomy is a better choice for minimally invasive treatment of renal pelvic cancer because of its advantages of less bleeding and no urinary fistula, less complications, easier operation and shorter learning curve. Has the promotion and application value.