肾石切除术

From April 2000 to June 2002, 512 cases of laparoscopical urologic operation have been performed through transperitoneal and retroperitoneal or extraperitoneal approach: 41 cases of nephrectomy, 36 cases of radical nephrectomy, 10 cases of nephroureterectomy with cystoscopic en bloc excision of the distal ureter and bladder cuff, 3 cases of partial nephrectomy, 78 cases of partial adrenalectomy or resection of adenomas, 71 cases of total adrenalectomy, 17 cases of ureterolithotomy, 122 cases of decortication of renal cyst, 1 case of Anderson-Hynes dismembered pyeloplasty, 7 cases of renal pedical lymphatics disconnection, 2 cases of relative living donor nephrectomy.

本课题通过对223例肾疾病、149例肾上腺疾病、17例输尿管结石病人进行腹腔镜及后腹腔镜手术，其中肾囊肿去顶术140例、单纯肾切除术41例、根治性肾切除术36例、肾输尿管全切及输尿管口膀胱袖套状切除术10例、后腹腔镜肾部分切除术3例、Anderson-Hynes肾盂成形术1例、肾蒂淋巴管离断术7例、腹腔镜和后腹腔镜活体亲属供肾切取术各1例、肾上腺部分或单纯肿瘤切除术78例、肾上腺全部切除术71例、输尿管切开取石术17例。记录手术时间、手术中失血量、肠道功能恢复时间及并发症，将结果与传统开放手术和国外学者的腹腔镜手术结果进行比较，对数据进行统计分析。

Methods Three hundred and fifty patients for laparoscopic surgery were admitted to our department from August 2001 to February 2002. They included 45 cases of adrenal glands surgery, 55 simple nephrectomy, 25 radical nephrectomy, 11 nephroureterectomy, 3 partial nephrectomy, 110 renal cyst decortication, 4 polycystic kidney decortication, 12 ureterolithotomy, 16 pyeloplasty, 3 retrocaval ureteroplasty, 58 varicocele-varix ligation and 8 pelvic lymph node dissection.

从2001年8月～2004年2月，350例患者施行了腹腔镜下泌尿外科手术，其中肾上腺手术45例，单纯肾切除55例，根治性肾切除25例，肾输尿管全切11例，肾部分切除3例，肾囊肿去顶术110例，多囊肾去顶减压术4例，输尿管切开取石术12例，UPJ成型术16例，腔静脉后输尿管成型术3例，精索静脉高位结扎术58例，盆腔淋巴结切除术8例。

It is necessary to block renal circulation temporarily in some complicated renal operations such as nephropyelolithotomy and nephron sparing nephrectomy of renal tumors.

在泌尿外科领域一些复杂的，肾脏手术，如肾实质切开取石术，肾肿瘤的肾部分切除术，暂时阻断血流是必要的。

There were no blood transfusion or serious complication in the study.Conclusions:Retroperitoneal laparoscopic operation,such as adrenalectomy,nephropexy,pelvioplasty,unroofing of renal cyst,pelvilithotomy,ureterdithotomy and spermatic vein ligation,have the advantages of minimai invasion,less blood loss and fewer complications,which is an effective and practical procedure.

后腹腔镜肾上腺瘤切除术、肾固定术、肾盂成形术、肾囊肿去顶术、肾盂或输尿管切开取石术及腹腔镜精索静脉高位结扎术具有创伤小、出血少、并发症少等优点，临床疗效可靠，实用性较强。

The split between the two groups can hardly be papered over.

这两个团体间的分歧难以掩饰。

This approach not only encourages a greater number of responses, but minimizes the likelihood of stale groupthink.

这种做法不仅鼓励了更多的反应，而且减少跟风的可能性。