自制腹膜反折悬吊装置在腹侧肾肿瘤后腹腔镜下肾部分切除术中的应用

目的 应用自制腹膜反折悬吊装置行腹侧肾肿瘤后腹腔镜下肾部分切除术，验证其安全性和可行性。方法 选择2018年1月至6月在海军军医大学（第二军医大学）东方肝胆外科医院泌尿外科行后腹腔镜下肾部分切除术治疗的腹侧肾肿瘤患者15例，术中应用自制简易腹膜反折悬吊装置（由Hem-o-lok夹和与之连接的穿刺器、固定装置及施夹钳组成）。15例患者中男9例、女6例，平均年龄为（62.5±9.2）岁，平均肿瘤最大径为（2.9±1.0）cm，均为位于肾脏腹侧的单发肿瘤。统计分析术中出血量、手术时间、肾热缺血时间、术后平均住院时间等临床资料。结果 15例患者后腹腔镜下肾部分切除术均顺利完成，平均手术时间为（88.9±24.5）min，平均肾热缺血时间为（21.4±4.6）min，平均术中出血量为（72.0±16.6）mL，平均术后住院时间为（6.9±1.2）d，术中、术后均未输血，也均未发生重大手术并发症。结论 应用自制腹膜反折悬吊装置行腹侧肾肿瘤后腹腔镜下肾部分切除术是安全可行的，便于手术操作，同时具有经济简便的优势，值得在临床推广。
Objective To explore the safety and feasibility of applying self-made peritoneal reflexed suspension device in retroperitoneoscopic partial nephrectomy for ventral renal tumors. Methods From Jan. 2018 to Jun. 2018, 15 patients with ventral renal tumors were treated by retroperitoneoscopic partial nephrectomy in Department of Urology of Eastern Hepatobiliary Surgery Hospital, Navy Medical University (Second Military Medical University). The self-made simple peritoneal retrorse suspension device was applied during the operation, and it consisted of the Hem-o-lok clamp and the associated puncture device, fixation device and clipper. Fifteen patients, aged (62.5±9.2) years, included 9 males and 6 females. All cases had single tumors located on the ventral side of the kidney, with an average maximum diameter of (2.9±1.0) cm. The clinical data, including intraoperative blood loss, operation time, renal warm ischemia time, average postoperative hospital stay and so on, were statistically analyzed. Results Retroperitoneoscopic partial nephrectomy was successfully performed on the 15 patients. The average operation time of 15 patients was (88.9±24.5) min, average renal warm ischemia time was (21.4±4.6) min, average intraoperative blood loss was (72.0±16.6) mL, and average hospital stay was (6.9±1.2) d. None of the 15 patients had blood transfusion or major surgical complications during or after operation. Conclusion This self-made peritoneal retrorse suspension device is safe and feasible in retroperitoneoscopic partial nephrectomy for ventral renal tumors, and is easy to operate during the operation. Meanwhile, it has the advantages of economy and convenience and is worthy of being popularized in clinical practice