单孔多通道腹腔镜泌尿外科手术单中心临床应用总结

发布时间：2018-03-07 22:34

本文选题：单孔腹腔镜手术　切入点：泌尿外科手术　出处：《第二军医大学学报》2011年10期 　论文类型：期刊论文

【摘要】：目的总结单中心100例次泌尿外科单孔多通道腹腔镜手术的临床疗效和经验。方法自2008年12月至2011年5月,98例患者先后在我科接受单孔多通道(TriPort TM)腹腔镜手术,其中2例患者行双侧手术,共完成各类手术100例次;其中肾癌根治术24例,肾脏部分切除术3例,无功能肾切除术10例,肾囊肿去顶减压术21例,单侧肾上腺切除术12例,输尿管切开取石术6例次,经膀胱前列腺剜除术9例,其他手术15例。收集患者基本信息、围手术期各项临床指标及随访资料并进行分析。结果 100例次单孔多通道腹腔镜手术中,87例手术在不增加任何辅助孔的情况下顺利完成,9例手术增加1个5mm的辅助孔,1例中转传统腹腔镜手术,3例中转开放手术。总体并发症发生率为15%(术中6%,术后9%)。前50例总体并发症发生率为5%,后50例为10%。手术疗效满意,美容效果好,肿瘤患者术后平均随访9.9±5.61(3～24)个月,未出现复发或转移。结论单孔腹腔镜技术在泌尿外科的应用安全、可行,创伤小,切口隐蔽。但早期应用阶段仍有一定的并发症发生率,应严格把握手术适应证。随着手术器械的进一步改进、临床经验的不断积累以及优化设计的前瞻性大样本多中心临床随机对照研究的完成,单孔腹腔镜技术将在泌尿外科疾病的诊治中发挥更大的优势。
[Abstract]:Objective to summarize the clinical effect and experience of 100 single-hole and multi-channel laparoscopic surgery in urology. Methods from December 2008 to May 2011, 98 patients underwent TriPort TMN laparoscopic surgery in our department. Two patients underwent bilateral surgery, including 24 cases of radical nephrectomy, 3 cases of partial nephrectomy, 10 cases of nonfunctional nephrectomy, 21 cases of decompression of renal cysts and 12 cases of unilateral adrenalectomy. Ureterotomy was performed in 6 cases, transurethral enucleation of the prostate (9 cases) and other operations (15 cases). Results among 100 single-channel laparoscopic operations, 87 cases were successfully completed without adding any auxiliary holes, and 9 cases underwent surgery with an additional 1 5 mm. The total incidence of complications was 15 (6 during operation, 9 after operation). The total incidence of complications in the first 50 cases was 5, and in the latter 50 was 10. The effect of operation was satisfactory. The cosmetic effect was good. The average follow-up of tumor patients was 9.9 卤5.61 卤3 / 24 months, and no recurrence or metastasis was found. Conclusion the application of single hole laparoscopy in urology is safe, feasible and less traumatic. The incision is concealed, but there is still a certain incidence of complications in the early stage of application, the indication of operation should be strictly grasped, and with the further improvement of the surgical instruments, With the continuous accumulation of clinical experience and the completion of a prospective, large sample, multicenter randomized controlled study, single-hole laparoscopy will play a greater role in the diagnosis and treatment of urologic diseases.
【作者单位】：第二军医大学长海医院泌尿外科;
【基金】：上海市市级医院新兴前沿技术联合攻关项目(SHDC12010115) 军队临床高新技术重大项目(2010gxjs057) 上海市重点学科项目~~
【分类号】：R699

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