经腹途径腹腔镜技术在肾癌根治术中的应用.docx

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 口例，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160mino术中出 血量约80-500 ml之间，平均125 mlo 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?T2NOMO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 carci no ma. Methods: 34 renal carcinoma were admitted to our department during Janualy 2011 to November2013- Of these cases, there were 23 males and lifemales whose ages ranging from 45?74 years old(mean age 55years). 18 cases had left一side and 16 had rightt一side. Less than 8 cm in diameter were treated by transabdominal laparoscopie radical nephrectomy. Results :ln 31 of 34 cases, nephrectomies were undergone successfully by laparoscopie procedure. In 3 cases, the procedure wag needed conversion to ope n sugerybecause of unc on trollable bleedi ng from injury to the fight renal artery, In lease, in jury of pan creas, cure after one mon th。Operativetime ran ged from 95-380min(mean operative time 160min). Intraoperative blood losses were about 80-500 ml(mean blood 125 ml). 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 3-0.5 years fellow-up.Conclusion:Apared to open radical neph