腹腔镜技术在泌尿外科中的应用
복강경기술재비뇨외과중적응용
Application of laparoscopic technique in urology: a 10-year experience with 2,000 cases
  • 万方数据
    上海医学 상해의학
    SHANGHAI MEDICAL JOURNAL
    2010年 3期 234-238,后插2 ,共6页

    徐丹枫%崔心刚%任吉忠%姚亚成%刘玉杉%高轶%车建平%滕怀宁%阴雷%陈明%李尧%王军凯%陈杰%陈露%闵志廉

    서단풍%최심강%임길충%요아성%류옥삼%고질%차건평%등부저%음뢰%진명%리요%왕군개%진걸%진로%민지렴

    腹腔镜%泌尿外科%应用 腹腔鏡%泌尿外科%應用
    복강경%비뇨외과%응용
    Laparoscopy%Urology%Application
    目的 总结第二军医大学附属长征医院采用腹腔镜技术处理泌尿外科疾患十余年2 000例患者的经验.方法 1999年1月-2009年9月,采用腹腔镜技术治疗泌尿系疾病患者2 000例,手术均采用全身麻醉,采用后腹腔入路1 821例,经腹腔入路179例;传统腹腔镜手术1 949例(包括器官毁损、切除术1 582例和器官保留、修复、重建术387例),单通道腹腔镜手术31例.结果 手术一次成功率为96.7%(1 934/2 000),手术时间为35～480 min,平均手术时间为(135±48)min出血量为10～3 500 mL,平均出血量为(40±25)mL,需要输血的病例为138例,占全部病例的6.9%;平均住院时间为(8.1±4.6)d,随访3～120个月.合并症发生率为5.5%(110/2 000),主要并发症为术中出血(2.6%,52/2 000)、高碳酸血症(1.5%,29/2 000)、切口感染(0.6%,12/2 000)、后腹腔脓肿(0.2%,4/2 000)及术后出血(0.45%,9/2 000)等.结论 传统腹腔镜手术技术已日益成熟,涉及泌尿外科的各种术式,可以达到满意的效果.单通道腹腔镜手术的切口更小,更美观,尽管操作难度较高,仍具有很大的推广应用价值.
    목적 총결제이군의대학부속장정의원채용복강경기술처리비뇨외과질환십여년2 000례환자적경험.방법 1999년1월-2009년9월,채용복강경기술치료비뇨계질병환자2 000례,수술균채용전신마취,채용후복강입로1 821례,경복강입로179례;전통복강경수술1 949례(포괄기관훼손、절제술1 582례화기관보류、수복、중건술387례),단통도복강경수술31례.결과 수술일차성공솔위96.7%(1 934/2 000),수술시간위35～480 min,평균수술시간위(135±48)min출혈량위10～3 500 mL,평균출혈량위(40±25)mL,수요수혈적병례위138례,점전부병례적6.9%;평균주원시간위(8.1±4.6)d,수방3～120개월.합병증발생솔위5.5%(110/2 000),주요병발증위술중출혈(2.6%,52/2 000)、고탄산혈증(1.5%,29/2 000)、절구감염(0.6%,12/2 000)、후복강농종(0.2%,4/2 000)급술후출혈(0.45%,9/2 000)등.결론 전통복강경수술기술이일익성숙,섭급비뇨외과적각충술식,가이체도만의적효과.단통도복강경수술적절구경소,경미관,진관조작난도교고,잉구유흔대적추엄응용개치.
    Objective To summarize our 10-year experience (about 2,000 cases) in using laparoscopic techniques for treatment of urological disorders in our center. Methods From Jan. 1999 to Sep. 2009, a total of 2,000 patients received laparoscopic surgery for urological disorders in our department under general anesthesia, with 1,821 via the retroperitoneal approach and 179 via transabdominal approach. Totally 1,949 cases received traditional laparoscopic surgery (including 1,582 cases with organ damage, resection and 387 cases with organ retention, restoration, and reconstruction) and 31 received single-port laparoscopic surgery. Results The success rate of surgery was 96.7% (1,934/2,000), and the operation time was 35 - 480 min, with a mean of (135±48) min. The bleeding volume ranged 10 - 3,500 mL and veraged (40±25) mL. There were 138(6.9%) cases who required blood transfusion. The average hospitalization stays was (8.1±4.6) d and the follow-up was 3- 120 months. Complication rate was 5.5% (110/2,000), including bleeding (2.6%, 52/2,000), hypercapnia (1.5%, 29/2,000), wound infection (0.6%, 12/2,000), abdominal abscess (0.2%, 4/2,000), postoperative bleeding (0.45%, 9/2,000), et al. Conclusion Traditional laparoscopic surgical techniques become more sophisticated, and it can be used for a variety of urological surgery types, which can achieve satisfactory results. Single port laparoscopic surgery has smaller incision and is aesthetically preferred. Although the operation is more difficult, it is still worth popluarizing.
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