CAJ | 학술논문

目的探讨经腹入路腹腔镜切除有开放手术史的肾脏的可行性.方法采用经腹入路腹腔镜切除有开放手术史的肾脏8例,均为无功能肾脏,男3例,女5例,年龄31～61岁,平均45岁,6例为巨大肾积水,2例为肾积脓而术前行经皮肾造瘘.结果 7例腹腔镜手术成功,1例术中改开放手术,术后无严重并发症发生,伤口感染1例,经处理后愈合.手术时间120～205 m0in,平均160 min,出血量100～600 ml,平均180 ml,术中输血l例.结论对于既往有肾脏开放手术史者,虽然因瘢痕粘连增加了手术难度,但随着腹腔镜手术经验的积累和手术技能的提高,行经腹入路腹腔镜肾脏切除术是可行的.
목적 탐토경복입로복강경절제유개방수술사적신장적가행성.방법 채용경복입로복강경절제유개방수술사적신장8례,균위무공능신장,남3례,녀5례,년령31～61세,평균45세,6례위거대신적수,2례위신적농이술전행경피신조루.결과 7례복강경수술성공,1례술중개개방수술,술후무엄중병발증발생,상구감염1례,경처리후유합.수술시간120～205 m0in,평균160 min,출혈량100～600 ml,평균180 ml,술중수혈l례.결론 대우기왕유신장개방수술사자,수연인반흔점련증가료수술난도,단수착복강경수술경험적적루화수술기능적제고,행경복입로복강경신장절제술시가행적.
Objective To explore the feasibility of transabdominal laparosCopic removal of the kidneys in patients with previous history of open renal surgery.Methods Transabdominal laparoscopic surgery was performed to resect 8 kidneys without finction.Two were male and three were female,with a mean age of 45 years ( 31 - 61 years ).6patients had giant hydronephrosis and the rest 2 had pyonephrosis and needed percutaneous nephrostomy.Results The procedure was successful in 7 patients and one patient had to receive open surgery during the procedure.No severe complications occurred postoperatively.One patient developed wound infection and was finally cured after treatment.The surgical duration was 120 - 205 min ( 160 min in average ); blood loss was 100 to 600 ml ( 180 ml in average ),with blood transfusion in one patient.Condusions For those with previous history of open kidney surgery,although surgical difficulty was increased because of scar adhesions,transabdominal laparoscopic nephrectomy is still feasible with an accumulation of experiences of laparoscopic surgery and improved surgical skills.