后腹腔镜肾切除术治疗常染色体显性遗传性多囊肾病：初步经验
Retroperitoneoscopic nephrectomy for autosomal dominant polycystic kidney disease: initial experience.
作者信息
Wyler Stephen F, Bachmann Alexander, Ruszat Robin, Forster Thomas, Hudolin Tvrtko, Gasser Thomas C, Sulser Tullio
机构信息
Department of Urology, University Hospital Basel, Basel, Switzerland.
出版信息
Urol Int. 2007;79(2):137-41. doi: 10.1159/000106327.
INTRODUCTION
Nephrectomy for autosomal dominant polycystic kidney disease (ADPKD) has been reported to have significant morbidity and mortality. Because of the large kidney size, laparoscopic nephrectomy is technically demanding and there have been only few reports on this subject. We describe our retroperitoneoscopic technique and review the literature.
METHODS
Retroperitoneoscopic nephrectomy was performed in 2 patients. A four-port retroperitoneal access was used, after hilar control the kidney was freed and extracted.
RESULTS
The mean operative time was 155 min, the mean intraoperative blood loss was 125 ml. There were no intraoperative complications. A postoperative retroperitoneal hematoma in 1 of the patients was managed conservatively with transfusion.
CONCLUSION
Retroperitoneoscopic nephrectomy for ADPKD is feasible. The main advantages of this technique compared to transperitoneal laparoscopy are the quick and easy access to the hilar vessels even in large polycystic kidneys and the strict extraperitoneal route.
引言
据报道，常染色体显性遗传性多囊肾病（ADPKD）肾切除术具有较高的发病率和死亡率。由于肾脏体积较大，腹腔镜肾切除术在技术上要求较高，关于这一主题的报道较少。我们描述了我们的后腹腔镜技术并回顾了相关文献。
方法
对2例患者实施后腹腔镜肾切除术。采用四孔后腹膜入路，控制肾门后游离并取出肾脏。
结果
平均手术时间为155分钟，平均术中出血量为125毫升。无术中并发症。1例患者术后出现后腹膜血肿，经输血保守治疗。
结论
后腹腔镜下ADPKD肾切除术是可行的。与经腹腹腔镜手术相比，该技术的主要优点是即使对于巨大多囊肾也能快速、轻松地显露肾门血管，且手术路径严格位于腹膜外。
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