经腹途径腹腔镜技术在肾癌根治术中的应用.docVIP

精品论文 参考文献 经腹途径腹腔镜技术在肾癌根治术中的应用 李英俊 (营口市中心医院泌尿外科 115000) 　　【摘要】目的 探讨经腹腹腔镜肾癌根治术的临床应用价值，分析临床效果及体会。方法 2010年10月-2014年1月共收治肾癌34例，男性23例，女性11例，年龄45-74岁(平均57岁)，肿瘤直径小于8 cm，肿瘤平均直径4．8cm，左侧18例，右侧16例，采用经腹腹腔镜肾癌根治术。结果 31例腹腔镜肾癌根治手术成功。3例中转开放手术，手术时间95-380 min，平均160min。术中出血量约80-500 ml之间，平均125 ml。10例穿刺口周围不同程度皮下气肿，4天后自行消失。术后24 小时下床活动，48 小时开始进食，术后7-9 d出院。随访0．5-3年，无肿瘤复发，无穿刺孔种植转移。结论 腹腔镜肾癌根治术刨伤小，对于TI～T2NOM0期肾肿瘤，经腹腹腔镜肾癌根治术安全有效，具有创伤小，术后恢复快，疼痛小等优点，效果优于开放手术：是一种安全．有效的治疗方法 。具有良好的临床应用前景。 　　【关键词】经腹途径 腹腔镜 肾癌根治术 　　【中图分类号】R737 【文献标识码】A 【文章编号】1672-5085（2013）40-0016-02 　　Transabdominal laparoscopic technique applied in radical operation of renal cell carcinoma Li Yingjun Department of Urology Yingkou 　　Central Hospital 　　【Abstract】Objective: To investigate clinical appplication value and reposed our experiences with transabdominal laparoseopie radical nephreetomy in thetreatment of patients with renal carcinoma．Methods: 34 renal carcinoma were admitted to our department during Janualy 2011 to November2013．Of these cases，there were 23 males and 11females whose ages ranging from 45-74 years old(mean age 55years)．18 cases had left—side and 16 had rightt—side． Less than 8 cm in diameter were treated by transabdominal laparoscopie radical nephrectomy．Results :In 31 of 34 cases，nephrectomies were undergone successfully by laparoscopie procedure．In 3 cases，the procedure wag needed conversion to open sugerybecause of uncontrollable bleeding from injury to the fight renal artery，In 1case，injury of pancreas，cure after one month。Operativetime ranged from 95-380min(mean operative time 160min)．Intraoperative blood losses were about 80-500 ml(mean blood 125 m1)．Subcutaneous emphysema around the ports sites in 3 cases spontaneously disappeared 3days post operation．The patients resumed activity 24 hours，began oral in take 48 hours and discharged 7 days post operation．No local lesion and port sites metastasis in34 caSes of these patients ocetuted in 3