单孔腹腔镜肾癌根治性切除术附22例报告-南方医科大学学报.PDFVIP

·274 · 南方医科大学学报（J South Med Univ ） 2012;32(2) 临床研究 单孔腹腔镜肾癌根治性切除术：附22 例报告 李虎林，徐啊白，许 凯，陈玢屾，刘春晓，郑少波，徐亚文，方 平，郭 凯，林阳彦，朱瑞龙 南方医科大学珠江医院泌尿外科，广东广州510282 摘要：目的探讨单孔腹腔镜肾癌根治性切除的方法、技巧和可行性分析。方法 2009 年1月~2011 年9 月，采用自制套管行单孔 腹腔镜肾癌根治性切除22 例，其中经脐10例，经后腹腔12例。经脐单孔采用经脐纵行切口，经后腹腔则采用腋后线12肋下横 行切口，长约5 cm ，进入腹腔或后腹腔，置入自制单孔套管，使用传统腹腔镜器械和弯曲的单孔器械相结合的方法进行操作。结 果22 例均顺利完成手术，无改开放，有5 例增加1到2 个工作通道，根治性肾切除平均耗时150（90~240）min ，术后住院平均7.6 （3~ 15）d ，手术疤痕约5 cm。结论单孔腹腔镜肾癌根治术安全可行，手术疤痕小而美观，随着手术器械的改进及手术技巧的提 高，单孔腹腔镜在肾癌根治方面有着良好的应用前景。 关键词：单孔；腹腔镜；根治性肾切除 中图分类号：R737.11 文献标志码：A 文章编号：1673-4254（2012）02-0274-03 DOI: CNKI:44-1627/R1540.034 /kcms/detail/44.1627.R1540.034.html Single-port laparoscopic surgery for radical nephrectomy: report of 22 cases LI Hulin, XU Abai, XU Kai , CHEN Binshen, LIU Chunxiao, ZHENG Shaobo, XU Yawen, FANG Ping, GUO Kai, LIN Yangyan, ZHU Ruilong Department of Urology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China Abstract: Objective To evaluate the method and technique of single-port laparoscopic radical nephrectomy. Methods Form January 2009 to September 2011, 22 patients with renal carcinoma were treated with single-port laparoscopic radical nephrectomy. An incision about 5 cm in length was made through the umbilicus or in the postaxillary line under the 12th rib to establish the peritoneal or retroperitoneal working space. A single-port cannulation was deployed and the operation was carried out using standard and crooked laparoscopic equipment. Results The operations were completed successfully in all the 22 cases without conversion to open surgery, but additional trocar was needed in 5 cases. The mean operative time of radical nephrectomy was 150 min (90-240 min). The mean postoperative hospital stay was 7.6 days (3-15 days). The operation left a roughly 5-cm-long scar in