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目的:建立利用自制单孔设备进行后腹腔镜下低温环境肾部分切除的手术方式,并评估安全性和可行性。方法:2011年6月~2011年9月采用自制单孔多通道设备,使用常规腹腔镜操作器械先后完成4例经后腹腔低温环境下的肾部分切除手术。结果:患肾均为右侧,平均手术时间126.5 min,术中出血量1 5~60 nml,肾平均缺血时间24.5 min。患者均顺利完成手术无中转开放,手术前后肾功能变化不大,均正常范围,1周左右出院,无手术并发症,术后病理均为肾透明细胞癌(T_(?))。结论:采用自制单孔多通道设备完成后腹腔镜低温环境下肾部分切除术技术可行,安全可靠,费用低;与常规腹腔镜手术相比,复杂性增加,但却可能延长肾缺血时间,保护残肾功能,是一种有应用前景的手术方式。
OBJECTIVE: To establish a surgical method of partial laparoscopic partial nephrectomy using a self-made single-hole device and assess the safety and feasibility. Methods: From June 2011 to September 2011, we performed self-made single-hole multichannel equipment and performed conventional partial laparoscopic partial nephrectomy in 4 patients undergoing retroperitoneal hypothermia. Results: All patients were on the right side with an average operation time of 126.5 min, intraoperative blood loss of 15 ~ 60 nml and mean renal ischemia time of 24.5 min. The patients were successfully completed the operation without transit to open, before and after surgery, little change in renal function, were normal range, 1 week or so discharged, no surgical complications, postoperative pathology were renal clear cell carcinoma (T_ (?)). Conclusion: The laparoscopic retroperitoneal laparoscopic partial nephrectomy is feasible, safe and reliable with low cost. Compared with conventional laparoscopic surgery, the complexity increases, but it may prolong the duration of renal ischemia, Protection of residual renal function, is a promising surgical approach.