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目的:探讨经后腹腔单通道腹腔镜技术行肾部分切除手术的技术方法和效果。方法:2009年12月～2010年12月,采用单通道腹腔镜技术,经后腹腔对6例单侧小肾癌的患者实施肾部分切除术,采用腰部腋中线切口,长约2.5 cm,置入自制的单切口Port,手术过程分别使用Cambridge endo可弯单通道腹腔镜器械、普通腹腔镜器械等。结果:6例手术均获得成功,未增加皮肤切口,未中转开放或传统腹腔镜手术,平均手术时间154.2(120～210)min,热缺血时间29(18～47)min,平均术中出血103.3(30～220)ml,术后住院时间为5.7(4～7)天,围手术期无并发症发生。术后随访2～14个月,无肿瘤复发、肾脏萎缩病例。结论:随着单通道腹腔镜器械的进一步改进和术者对单通道腹腔镜操作熟练程度的提高,在严格筛选病例的前提下,经后腹腔单通道腹腔镜肾部分切除术是安全可行的。
Objective: To explore the technique and effect of partial nephrectomy with trans laparoscopic single-channel laparoscopy. METHODS: From December 2009 to December 2010, 6 patients with unilateral small renal cell carcinoma underwent retroperitoneal nephrectomy by single-channel laparoscopic technique. The midline incision of the midline of the waist was used and the length was about 2.5 cm Into a single-incision port, the surgery were used single-port lacrimal Cambridge endo flexible laparoscopic instruments, laparoscopic instruments and so on. Results: All the 6 surgeries were successful. No skin incision, untransplantation or conventional laparoscopic surgery were performed. The average operation time was 154.2 (120-210) min and the warm ischemia time was 29 (18-47) min. The average intraoperative bleeding 103.3 (30 ~ 220) ml, postoperative hospital stay was 5.7 (4 ~ 7) days, no complications during perioperative period. Follow-up 2 to 14 months after surgery, no tumor recurrence, renal atrophy cases. Conclusion: With the further improvement of single-channel laparoscopic instruments and surgeons’ proficiency in single-channel laparoscopic operation, laparoscopic transabdominal laparoscopic partial nephrectomy is safe and feasible under the strict screening of cases.