CAJ | 학술논문

目的总结脐部单切口三孔腹腔镜在泌尿外科手术中的应用经验. 方法脐部单切口三孔腹腔镜手术32例.男10例,女22例.平均年龄22(16～35)岁.其中精索静脉曲张7例、单纯性肾囊肿12例、双侧肾囊肿1例、多囊肾1例、左侧肾上腺肿瘤3例、右侧肾上腺肿瘤1例、左侧输尿管上段结石1例、重度肾积水2例、萎缩无功能肾4例.在脐部作1.0～3.0 cm切口,置入3只10 mm或5 mm套管作为视孔及操作孔,腹腔镜下常规操作,完成泌尿外科手术. 结果精索静脉曲张手术时间平均15(10～20)min,术中无明显出血;肾囊肿手术时间平均40(30～53)min,术中无明显出血;肾上腺肿瘤手术时间平均68(57～120)min,术中出血量平均30(20～60)ml;输尿管切开取石86 min,术中出血50 ml,肾切除手术时间平均65(45～135)min,术中出血量平均110(90～150)ml.术后排气时间平均8.5(4～12)h.住院时间平均5.5(3～8)d.32例平均随访时间2(1～3)个月,脐部切口愈合好,腹部无可见瘢痕,无脐疝等并发症. 结论脐部单切口三孔腹腔镜治疗泌尿外科疾病安全有效,可使泌尿外科手术成为一种无瘢痕的美容手术.
목적 총결제부단절구삼공복강경재비뇨외과수술중적응용경험. 방법제부단절구삼공복강경수술32례.남10례,녀22례.평균년령22(16～35)세.기중정색정맥곡장7례、단순성신낭종12례、쌍측신낭종1례、다낭신1례、좌측신상선종류3례、우측신상선종류1례、좌측수뇨관상단결석1례、중도신적수2례、위축무공능신4례.재제부작1.0～3.0 cm절구,치입3지10 mm혹5 mm투관작위시공급조작공,복강경하상규조작,완성비뇨외과수술. 결과정색정맥곡장수술시간평균15(10～20)min,술중무명현출혈;신낭종수술시간평균40(30～53)min,술중무명현출혈;신상선종류수술시간평균68(57～120)min,술중출혈량평균30(20～60)ml;수뇨관절개취석86 min,술중출혈50 ml,신절제수술시간평균65(45～135)min,술중출혈량평균110(90～150)ml.술후배기시간평균8.5(4～12)h.주원시간평균5.5(3～8)d.32례평균수방시간2(1～3)개월,제부절구유합호,복부무가견반흔,무제산등병발증. 결론제부단절구삼공복강경치료비뇨외과질병안전유효,가사비뇨외과수술성위일충무반흔적미용수술.
Objective To explore the feasibility of the three-port laparoscopic surgery through single umbilical incision with urological desease. Methods Thirty-two patients (10 males and 22 females) were taken the laparoscopic surgery using three ports through single incision. Including varicocele 7 cases, simple kidney cyst 12 cases, double kidney cyst 1 case, polycystic kidney 1 case, left adrenal tumor 3 cases, right adrenal tumor 1 cases, left upper ureteral calculi 1 cases, giant hydronephrosis 1 case and atrophic kidney 4 cases. The surgery procedures were including make a 1.0-3.0 cm long incision in the navel, followed by inserting three 10 mm or 5 mm trocars in the incision for observation and operation. Conventional laparoscopic techniques were used to complete the urological surgery. Results The operation time of varicoeele ligation was 10--20 rain, mean 15 min, no intraoperative bleeding. The operation time of renal cysts was 30-53 min, mean 40 rain, no intraoperative bleeding. The operation time of resection of adrenal tumor was 57--120 min, mean 68 rain, intraoperative bleeding was 20-60 ml, mean 30 ml. The operation time of ureterolithotomy was 86 min, intraoperative bleeding was 50 ml. The operation time of nephrectomy was 45-135 min, mean 65 min, intraoperative bleeding was 90-150 ml, mean 110 ml. Length of stay 3-8 days, average 5.5 days.With average follow-up time 2 months, all cases were fully recovered without complication and no visible scar in the abdominal region. Conclusion The laparoscopic surgery using three ports through single incision is safe and effective in selected urological surgery.