CAJ | 학술논문

目的探讨肥胖型肾癌患者后腹腔镜下根治性肾切除术中不同位置辅助性套管的应用体会. 方法回顾性分析2004年3月至2010年12月完成61例肥胖型T1～T2肾癌患者后腹腔镜下根治性肾切除术,根据肿瘤部位合理选择不同位置辅助性套管:肿瘤位于中上极者于腋中线肋缘下1 cm处置入辅助性套管,肿瘤位于中下极者于腋中线髂嵴上1 cm腹侧4 cm处置入辅助性套管,观察临床效果. 结果 61例手术均成功,无中转开放手术者.手术时间(153.1±23.5)min,术中出血量(57.6±29.7) ml,术后住院时间(5.7±2.6)d,术中发生腹膜破裂5例,切口脂肪液化4例,无严重并发症发生. 结论肥胖患者后腹腔镜下根治性肾切除术中根据肿瘤部位合理选择不同位置的辅助性套管手术安全性高,患者能更好地受益于微创手术治疗.
목적 탐토비반형신암환자후복강경하근치성신절제술중불동위치보조성투관적응용체회. 방법 회고성분석2004년3월지2010년12월완성61례비반형T1～T2신암환자후복강경하근치성신절제술,근거종류부위합리선택불동위치보조성투관:종류위우중상겁자우액중선륵연하1 cm처치입보조성투관,종류위우중하겁자우액중선가척상1 cm복측4 cm처치입보조성투관,관찰림상효과. 결과 61례수술균성공,무중전개방수술자.수술시간(153.1±23.5)min,술중출혈량(57.6±29.7) ml,술후주원시간(5.7±2.6)d,술중발생복막파렬5례,절구지방액화4례,무엄중병발증발생. 결론 비반환자후복강경하근치성신절제술중근거종류부위합리선택불동위치적보조성투관수술안전성고,환자능경호지수익우미창수술치료.
Objective To evaluate the effect of auxiliary trocar located on various positions on obese patients treated with retroperitoneoscopic radical nephrectomy. Methods Retrospective analysis was performed for 61 consecutive obese patients who underwent retroperitoneoscopic radical nephrectomy for localized renal cell carcinoma at our institution from March 2004 to December 2010.An auxiliary trocar was placed into retroperitoneal space according to the position of tumor.It was placed infro-costal magin in the mid-axillary line with uppre-median pole tumor,and 4 cm medial to mid-axillary line and 1 cm cephalad to illac spine with lower-median pole,respectively. Results All 61 patients were completed successfully with no conversion to open surgery.Mean operating time was ( 153.1 ± 23.5 ) min.Mean estimated blood loss was (57.6 ±29.7) ml.Mean hospital stay after operation was (5.7 ±2.6) d.The rupture of peritoneum and liquefaction of fat were occurred in 5 and 4 patients respectively.There was no major intraoperative and postoperative complications occurred. Conclusions Reasonable position of the auxiliary trocar according to the tumor's location would be safe and feasible on obese patients treated with retroperitoneoscopic radical nephrectomy.Obese patients with localized renal cell carcinoma would better benefit from minimally invasive procedure.