目的:评价经阴道纯自然腔道内镜手术(NOTES)肾切除术的临床可行性和有效性。方法:对1例右肾无功能和1例左肾结石并左肾萎缩、左肾无功能的女性患者行经阴道纯NOTES肾切除术。患者取全麻,截石位。切开阴道后穹窿,置入Triport及操作器械。所有操作均经此Triport完成,按照普通腹腔镜肾切除方法游离并切除患肾,装入自制标本袋,自阴道后穹窿切口取出。留置盆腔引流管,缝合阴道后穹窿切口。结果:手术均顺利完成,术中未出现肠管、实质性器官和大血管损伤等并发症。手术时间分别为330 min、300 min,术中失血量分别为300 ml、250 ml。例1、2分别于术后第2、1天下床活动,第3、2天肛门通气并进饮食。2例均于术后第6天痊愈出院,患者体表均无切口或穿刺孔。结论:经阴道纯NOTES肾切除术临床应用可行,美容优势明显,可在临床选用。但仍需进一步研发、完善相关器械。 Objective: To evaluate the clinical feasibility and effectiveness of transvaginal nephrectomy (NOTES). Methods: One case of right renal dysfunction and one case of left renal calculi with left renal atrophy were treated by transvaginal NOTES nephrectomy in female patients with left renal dysfunction. Patients take general anesthesia, lithotomy position. Vaginal posterior vaginal incision, into the Triport and operating equipment. All operations were completed by this Triport, in accordance with the normal method of laparoscopic nephrectomy and removal of diseased kidneys, homemade bags loaded, removed from the vaginal fornix incision. Indwelling pelvic drainage tube, suture vaginal fornix incision. Results: The operation was successfully completed. No complications such as bowel, substantial organs and macrovascular injury occurred during operation. The operative time was 330 min and 300 min respectively. The intraoperative blood loss was 300 ml and 250 ml respectively. Cases 1 and 2, respectively, on the 2nd and the 1st postoperative ambulation, the first 3, 2 days anal ventilation and into the diet. Both cases were cured and discharged on the 6th day after operation. There was no incision or puncture in the body surface of the patients. Conclusion: Transvaginal pure NOTES nephrectomy is feasible and has obvious cosmetic advantages. It can be used clinically. But still need further research and development, improve related equipment.