Matsuda T, Uchida J, Kawamura H, Komatz Y, Fujise K, Terachi T, Horii Y, Yoshida O
Department of Urology, Kansai Medical University.
Hinyokika Kiyo. 1992 Jul;38(7):759-65.
Laparoscopic procedures are promising techniques which allow less invasive surgery not only for intra-abdominal organs but also for retroperitoneal organs. Laparoscopic nephrectomy was first described by Clayman et al. We removed the left kidney of a 36-year-old male patient using laparoscopic procedures according to Clayman's technique. The kidney had developed hydronephrosis due to congenital ureteropelvic junction stenosis. In the peritoneal cavity the freed kidney was pushed into a Lapsac, minced using scissors and forceps, and removed without elongation of the wound. During the operation, pneumoperitoneum with CO2 gas induced increases in PaCO2, central venous pressure, pulmonary artery wedge pressure and cardiac output, all of which the patient tolerated well. The patient was discharged from the hospital on the 9th postoperative day. Laparoscopic nephrectomy is a useful alternative to the conventional open surgery in selected cases, when surgical techniques and instruments are improved appropriately.
腹腔镜手术是很有前景的技术，它不仅能对腹腔内器官，还能对腹膜后器官进行微创外科手术。腹腔镜肾切除术最早由克莱曼等人描述。我们根据克莱曼的技术，采用腹腔镜手术切除了一名36岁男性患者的左肾。该肾脏因先天性肾盂输尿管连接处狭窄而出现肾积水。在腹腔内，游离的肾脏被放入一个拉萨克袋中，用剪刀和镊子切碎，然后在不延长伤口的情况下取出。手术过程中，二氧化碳气腹导致动脉血二氧化碳分压、中心静脉压、肺动脉楔压和心输出量增加，但患者耐受良好。患者术后第9天出院。在适当改进手术技术和器械的情况下，腹腔镜肾切除术在某些选定病例中是传统开放手术的一种有用替代方法。
