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目的 总结分析2621例腹膜后腹腔镜手术的临床资料。 方法 2002-2009年在北京协和医院泌尿外科行腹膜后腹腔镜手术病例2621例, 分别对患者的性别、年龄、术前诊断、手术方式、手术时间、术中出血量、住院日和并发症等资料进行统计分析。 结果 2621例患者中男性1271例, 女性1350例, 年龄8~86岁(平均48.9岁)。所有患者均接受了腹膜后腹腔镜手术治疗, 其中肾上腺手术1410例, 占53.79%;肾脏手术1041例, 占39.72%;肾盂、输尿管手术170例, 6.49%。手术时间20~120min (平均60.5min); 出血量10~1500ml (平均85.2ml); 住院日3~97d (平均20.6d), 术后住院日2~35d (平均6.5d)。共发生各类并发症191例, 均得到及时处理。 结论 腹膜后腹腔镜手术技术已逐渐成熟, 在泌尿外科得到广泛应用, 已逐渐替代传统手术方式。 Abstract:Objective To summarize the clinical experiences of 2621 patients treated with retroperitoneal laparoscopic surgery. Methods Totally 2621 patients[1271 males and 1350 females; aged 8-86 years (mean 48.9 years)] were treated with retroperitoneal laparoscopic surgery from 2002 to 2009 in the Urology Department of Peking Union Medical College Hospital. The demographic and clinical data of these patients were retrospectively analyzed. Results Among these patients, 1410 patients (53.79%) underwent adrenal surgery, 1041 (39.72%) underwent renal surgery, and 170 (6.49%) underwent renal pelvis and ureter surgery, with an operating time of 20-120 minutes (mean:60.5 minutes) and a intra-operative bleeding volume of 10-1500 ml (mean:85.2 ml). The overall hospital stay was 3-97 days (mean:20.6 days) and the postoperative hospital stay was 2-35 days (mean:6.5 days). Complicatons were noted in 191 patients and were well managed. Conclusions The retroperitoneal laparoscopic surgical technique has been widely used in urology department. It has been proven to be safe and effective. -
Key words:
- retroperitoneal /
- laparoscopy /
- surgery /
- complications
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表 1 2621例腹膜后腹腔镜手术患者临床数据统计
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[1] Thiel DD, Petrou SP. Eletroresection and open surgery[J]. Urol Clin North Am, 2009, 36: 461-470. doi: 10.1016/j.ucl.2009.08.001 [2] Shivde SR, Eden CG. Retroperitoneal laparoscopy[J]. BJU Int, 2000, 85: 777. [3] Gagner M, Laroix A, Bolte E. Laparoscopic adrenalectomy in Cushing's syndrome and pheochromocytoma[J]. N Engl J Med, 1992, 327: 1033. doi: 10.1056/NEJM199210013271417 [4] 李汉忠, 臧美孚, 徐大华, 等, 腹腔镜肾上腺肿瘤切除[J].中华外科杂志, 1994, 32: 345-347. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=QK199400610265 [5] Hovhannisyan S. Differential characteristics of open and laparoscopic adrenalectomy[J]. Georgian Med News, 2010, 179:10-14. http://cn.bing.com/academic/profile?id=df2c16a658095224ef65b124d7a45fd3&encoded=0&v=paper_preview&mkt=zh-cn [6] Borin JF. Laparoscopic radical nephrectomy: long-term outcomes[J]. Curr Opin Urol, 2008, 18:139-144. doi: 10.1097/MOU.0b013e3282f4a851 [7] Parsons JK, Varkarakis I, Rha KH, et al. Complications of abdominal urologic laparoscopy: longitudinal five-year analysis[J]. Urology, 2004, 63: 27-32. doi: 10.1016/j.urology.2003.10.003 -
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