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其他题名Retroperitoneal laparoendoscopic single-site adrenalectomy using self-made single-port device: Initial Experience
方冬; 郝瀚; 瓦斯里江; 瓦哈甫; 张崔建; 虞巍; 张争; 李学松; 周利群
关键词肾上腺切除术 单孔腹腔镜 腹膜后镜 Adrenalectomy Laparoendoscopic Single-site Surgery Retroperitoneoscopy
文章类型Journal Article
摘要[目的]探讨采用自制套管进行单孔腹膜后镜肾上腺切除术的可行性和初步经验.[方法]2010年6月至2011年8月北京大学第一医院共有9例患者行单孔腹膜后镜肾上腺切除术.患者平均年龄59岁(32 ~80岁),男5例,女4例,平均BMI为24.1 kg/m2.所有手术均为腹膜后入路,选择腋中线与腋后线之间髂嵴上方3cm处斜行切口,切口长度3~4 cm.先以气囊扩张建立腹膜后腔,然后置入以手套自制单孔多通道套管建立手术入路,采用前端可弯曲腹腔镜器械联合常规腹腔镜器械完成手术,在术毕从切口取出标本.[结果]肿瘤长径平均3.3 cm(1.5~5.5 cm),左侧3例,右侧6例.平均手术时间62min(40~127 min),术中平均出血量为50 ml(0 ~200ml).9例手术均顺利完成,无中转开放手术或增加附加套管,无术中、术后并发症发生.平均术后住院时间为5 d(3 ~7 d).[结论]对于选择合适的病例,采用自制套管行单孔腹膜后镜肾上腺切除术是安全可行的,具有一定的美观效果,但远期疗效尚待观察,手术器械及手术技术尚待完善. [Objective]To present our clinical experience with retroperitoneal laparoendoscopic single-site surgery (LESS) of adrenalectomy using self-made single-port device.[Methods] Between June 2010 and August 2011,a total of 9 patients with adrenal adenoma underwent retroperitoneal LESS adrenalectomy by one experienced surgeon.The mean age was 59(32-80)years with 5 male and 4 female patients,and the mean BMI was 24.1 kg/m2.All procedures were carried out retroperitoneally through an incision 3 cm above the iliac crest,the length of which was 3 to 4 cm,.After extending the retroperitoneal cavity with a bailonet,a self-made single-port device was placed and surgery procedures were performed with flexible and standard laparoscopic instruments.All specimens were extracted intact through the incision.[Results] The mean diameter of adenomas was 3.3 cm( 1.5-5.5 cm) with 3 at the left side and 6 at the right.The mean estimated blood loss (EBL) was 50 ml(0-200 ml),and the mean operation time was 62 minutes (40-127 minutes).All procedures were completed successfully with no conversion to standard multiport laparoscopic or open surgery and there were no intra-operative or post-operative complications.Postoperative hospital stay was 5 (3-7)days.[Conclusions]For proper selected patients,the retroperitoneal LESS adrenalectomy is safe and feasible with better cosmetic outcome,but further observation is needed for long-term outcome as well as improvement of the instruments and surgery technique.
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方冬,郝瀚,瓦斯里江,等. 自制套管单孔腹膜后镜肾上腺切除术初步经验总结[J]. 中华临床医师杂志(电子版),2012,06(9):112-115.
APA 方冬.,郝瀚.,瓦斯里江.,瓦哈甫.,张崔建.,...&周利群.(2012).自制套管单孔腹膜后镜肾上腺切除术初步经验总结.中华临床医师杂志(电子版),06(9),112-115.
MLA 方冬,et al."自制套管单孔腹膜后镜肾上腺切除术初步经验总结".中华临床医师杂志(电子版) 06.9(2012):112-115.
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