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目的:初步应用单孔多通道3D腹腔镜进行肾癌手术,探讨该手术是否安全可行,评估其优缺点和临床应用前景。方法:我中心从2014年1月起开展单孔多通道3D腹腔镜肾癌手术,至2015年1月共开展肾癌根治术6例,肾部分切除术2例。我们收集了8例患者的基本信息、住院期间各项临床指标及随访资料并进行分析。结果:8例患者手术均顺利完成,并未增加任何辅助切口。本组肾癌根治术和肾部分切除术的手术时间分别为(216.7±51.3)min、(217.5±31.8)min,术中出血分别为(336.7±443.9)ml、(100.0±70.7)ml。其中2例肾部分切除术热缺血时间为16min和24min。术中术后未输血,未出现并发症。患者于术后(2.4±0.5)天恢复胃肠功能,术后住院天数为(5.3±1.4)d。术后平均随访(25.5±3.7)个月,随访期间无肿瘤复发,切口无明显手术瘢痕,体表毁损程度小。结论:单孔多通道3D腹腔镜既具有单孔腹腔镜体表毁损程度小、术后患者疼痛轻、恢复快、切口及Trocar穿刺点相关并发症少等优点,又结合了3D腹腔镜图像立体感强、手术操作精确度高的优势,在一定程度上可以降低单孔腹腔镜缝合、打结等操作的难度,具有良好的临床应用前景。
OBJECTIVE: To preliminarily apply single-hole, multi-channel 3D laparoscopy for renal cell carcinoma to explore whether the operation is safe and feasible, and to evaluate its advantages and disadvantages and clinical application prospects. Methods: From January 2014, our center performed single hole multi-channel laparoscopic 3D laparoscopic kidney cancer surgery. By January 2015, 6 cases of radical nephrectomy and 2 partial nephrectomy were performed. We collected the basic information of 8 patients, various clinical indicators during hospitalization and follow-up data and analysis. Results: All 8 patients completed the operation successfully without any additional incision. The operative time of radical nephrectomy and partial nephrectomy were (216.7 ± 51.3) min and (217.5 ± 31.8) min, respectively, and the intraoperative bleeding was (336.7 ± 443.9) ml and (100.0 ± 70.7) ml respectively. Two cases of partial nephrectomy warm ischemia time of 16min and 24min. No intraoperative blood transfusion, no complications. The patients recovered their gastrointestinal function after (2.4 ± 0.5) days and the postoperative hospital stay was (5.3 ± 1.4) days. The average follow-up after operation was (25.5 ± 3.7) months. No tumor recurrence was observed during the follow-up. There was no obvious surgical scar in the incision and the degree of surface damage was small. Conclusions: The single-hole multi-channel 3D laparoscopy has both the advantages of single-hole laparoscopic surgery with less degree of surface damage, less postoperative pain, quicker recovery, fewer complications related to incision and Trocar puncture, combined with 3D laparoscopic image stereoscopic Strong sense of the advantages of high accuracy surgery, to a certain extent, can reduce the single-hole laparoscopic suture, knotting and other operations more difficult, with good clinical application prospects.