自制尿道辅助器械在经脐单孔腹腔镜下尿路手术中的应用

doi:10.19558/j.cnki.10-1020/r.2018.04.002

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摘要 目的: 探讨在经脐单孔腹腔镜下尿路手术中使用自制尿道辅助器械的可行性及意义。方法: 回顾性分析2014年12月~2016年6月112例根治性前列腺切除术,38例根治性全膀胱切除+输尿管腹壁造口术以及8例根治性全膀胱切除+正位膀胱术患者资料。158例采用经脐多通道套管,术中使用自制尿道辅助器械实施经脐单孔腹腔镜手术,对围手术期相关资料进行分析。结果: 158例患者手术均获成功,无一例术中增加通道或转开放。根治性前列腺切除术平均手术时间(126.0±62.1)min,术中平均出血(112.0±45.2)ml,平均住院(12.4±3.2)d,根治性全膀胱切除+输尿管腹壁造口术平均手术时间(215.0±58.7)min,术中平均出血(150.0±51.1)ml,平均住院(9.7±2.1)d,根治性全膀胱切除+正位膀胱术平均手术时间(338.0±87.5)min,术中平均出血量(250.0±68.6)ml,平均住院(17.4±4.6)d。158例患者均无直肠等周围组织损伤并发症。结论: 尿道途径辅助下经脐单孔腹腔镜下尿路手术可以降低手术难度,缩短手术时间,是安全可行的。

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	徐国江
	王宁红
	朱清毅
	魏云飞

关键词 ：经脐单孔腹腔镜, 下尿路手术, 自制, 尿道辅助器械

Abstract：Objective: To explore the feasibility and significance of home-made transurethral instruments in transumbilical laparoendoscopic single-site (TU-LESS) lower urinary tract surgery. Methods: From December 2014 to June 2016, a total of 158 patients underwent TU-LESS lower urinary tract surgeries, including 112 cases of LESS radical prostatectomy (RP), 38 cases of LESS radical cystectomy (RC) with cutaneous ureterostomy and 8 cases of LESS RC with orthotopic ileal neobladder. Home-made transurethral instruments were utilized during the operation. The perioperative data were collected and analyzed retrospectively. Results: All the procedures were completed successfully. No additional ports were added and no conversion to open surgery was necessary. For LESS RP, the average operating time was (126.0±62.1) min. Estimated blood loss was (112.0±45.2) mL. The mean postoperative hospital stay was (12.4±3.2) days. For LESS RC with cutaneous ureterostomy, the average operating time was (215.0±58.7) min. Estimated blood loss was (150.0±51.1) mL. The mean postoperative hospital stay was (9.7±2.1) days. For LESS RC with orthotopic ileal neobladder, the average operating time was (338.0±87.5) min. Estimated blood loss was (250.0±68.6) mL. The mean postoperative hospital stay was (17.4±4.6) days. No rectum injury was found in all patients. Conclusions: With the aid of home-made transurethral instruments, LESS lower urinary tract surgery was proved to be safe and feasible. The difficulty of the operation was significantly decreased and the operating time was shortened.

Key words： trasumbilical laparoscopic single site surgery lower urinary tract surgery home-made transurethral instruments

收稿日期: 2018-02-10

ZTFLH:

R69

基金资助:国家实用新型专利(ZL 2015 2 0346229.0)

通讯作者: 王宁红,wnhxx@163.com

引用本文:

徐国江, 王宁红, 朱清毅, 魏云飞. 自制尿道辅助器械在经脐单孔腹腔镜下尿路手术中的应用[J]. 微创泌尿外科杂志, 2018, 7(4): 221-224.
Xu Guojiang, Wang Ninghong, Zhu Qingyi, Wei Yunfei. Application of home-made transurethral instruments in transumbilical laparoendoscopic single-site lower urinary tract surgery. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2018, 7(4): 221-224.

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http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1423.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2018/V7/I4/221

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