论文部分内容阅读
目的总结后腹腔镜下巨大积水无功能肾切除术中肾蒂处理技巧。方法选取我院2015年5月~2016年6月收治患者51例作为研究对象,建立后腹膜腔后将肾周易游离的面尽可能游离,刺破肾脏吸尽积水,从上而下,自肾上极开始充分游离暴露肾蒂,用Hem-o-lok依次结扎肾动静脉,最后游离肾脏其他面及处理输尿管。结果患者51例手术顺利,术中均未输血,手术时间(90~180)min,平均手术时间120 min,术中出血(10~120)m L,平均30 m L。术后1例因粘连剥离面渗血而形成肾窝血肿,输血400 m L,其余病例均未输血。无中转开放病例。结论巨大肾积水后腹腔镜肾切除术中处理肾蒂时,自上而下,由肾上极开始游离可迅速找到肾蒂血管并结扎。后腹腔镜巨大肾积水切除安全可靠、微创、恢复快。但对于因感染等原因导致肾周严重粘连者则应慎重。
Objective To summarize the treatment of renal pedicle during laparoscopic non-functional nephrectomy with massive hydrocephalus. Methods Fifty-one patients admitted to our hospital from May 2015 to June 2016 were selected as the research object. After the peritoneal cavity was established, the surface of the perinephric kidney was separated as much as possible, and the kidney was punctured to drain stagnant water. From top to bottom, Kidney pole began to fully expose the renal pedicle free, with Hem-o-lok ligation of the renal artery and vein, and finally free the other side of the kidney and ureter treatment. Results The operation was successful in 51 cases. No blood transfusion was performed during operation. The operation time (90-180) min, mean operation time 120 min, intraoperative bleeding (10-120) m L, average 30 m L. Postoperative one case due to adhesion peel surface bleeding and formation of renal cell hematoma, transfusion 400 m L, the remaining cases were not transfused. No transfer to open cases. Conclusions In the treatment of renal pedicle after laparoscopic nephrectomy with huge hydronephrosis, the pedicle of the renal pedicle can be quickly found and ligated from top to bottom and free from the superior pole of the kidney. Retroperitoneal laparoscopic hydronephrectomy safe, minimally invasive, fast recovery. However, due to infection and other causes of severe renal perineal adhesions should be careful.