经脐单孔腹腔镜肾囊肿去顶减压术初步应用和评价11.29副本.docVIP

经脐单孔腹腔镜肾囊肿去顶减压术的初步应用与评价【摘要】目的：初步评价经脐单孔腹腔镜肾囊肿去顶减压术(transumbilical single
port laparoscopic renal cystectomy )的临床应用效果。方法：2010年8月至12月在我院初步开展经脐单孔腹腔镜肾囊肿去顶减压术4例，观察手术的可行性、安全性、微创性及美容效果。结果：4例手术均取得成功。手术时间50-95min，平均75min；出血量5-10ml，平均8.3ml；均未放置引流管；术后1-3天可下床活动，住院时间10-12d，平均10.7d；术后2周复查脐部未见明显手术瘢痕，1-6个月复查均未发现囊肿复发。结论：经脐单孔腹腔镜肾囊肿去顶减压术不但安全可行、疗效肯定，而且较传统腹腔镜更加微创，故极具推广价值，但是该方法较常规腹腔镜技术操作难度大。我们认为:在开展单孔腹腔镜的初级阶段，可以选择性的进行经脐单孔腹腔镜肾囊肿去顶减压术，随着操作的进一步熟练，有望为在单孔腹腔镜下进行肾上腺切除及肾盂输尿管整形等较复杂的手术奠定基础。【Abstract】 Objective:To initial evaluate the clinical application effect of transumbilical single-port laparoscopy for unroofing of renal cyst.Methods:From August to Decembein 2010,transumbilical single-port laparoscopic renalcystectomy for four patients with renal cyst was performed. The feasibility, safety, minimal invasiveness and cosmeticresult of thetechnique were observed.Results：All procedurswere technically successful. The mean operating time was75（50-95）minutes.The mean estimated blood loss was 8.3 （5-10）ml.No drainagetube was placed;The mean hospital stay was 11.7 days. No intraoperative complications occurred. There was novisible scar on theabdominal wall . No local recurrence was observed during a follow up of 1-6 months. Conclusions: transumbilical single-port laparoscopic renalcystectomy is not only a safe feasible and effective option for patients with renal cyst, but also has more advantages of mini-invasion effect.so it has great extension value.However,the performing of this operation is difficult, Soour experience is that in elementary stage of carrying outthe LESS,we should selectively do this operation for patients with renal cyst，Along with the further operation skills,I believe that it will lay the foundation for some morecomplex surgery,such as adrenalectomy, HYPERLINK app:ds:pyeloureteroplasty \t _self pyeloureteroplasty.【Key words】:Transumbilical; Laparoscopy; Single-portrenal cystectomy随着微创外科技术的发展和患者生活质量的进一步提高，最大程度的减少手术创伤和美容效果成为外科医师的追求。为此，2010年8月至12月，在我院初步开展经脐单孔腹腔镜肾囊肿去顶减压术4例，均取得成功，现