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目的 探讨后腹腔镜积水无功能肾切除术的手术方法和效果.方法 对5例积水无功能肾患者行后腹腔镜积水无功能肾切除术.腰部3个Trocar穿刺入路,手指法建立后腹膜气腹,游离出部分病变肾脏后先肾脏切开一小口,吸净积水肾内的积水,然后再游离肾脏,暴露肾蒂后,用钛夹或Hem-o-lock夹闭肾蒂并切断,将积水无功能肾切除并置入标本袋后取出.结果 5例手术均获得成功,手术时间为150～300 min,平均为170 min.术中出血10～80 ml,平均30 ml.引流管于术后2～3 d拔除,无大出血、感染、腹膜破裂、腹腔脏器损伤等并发症.结论 后腹腔镜积水无功能肾切除术是一种微创、安全、有效、恢复快的术式,必将成为此类疾病治疗的首选方法.

Objective To evaluate the operation method and results of retroperitoneoscopic nephrectomy on the treatment of non-functioning kidney with hydronephrosis.Methods Retroperitoneoscopic nephrectomy was performed in 5 cases with nonfunctioning kidney with hydronephrosis.The retroperitoneal cavity were established with the fingers separating method.Afterwards ,3 Trocars were inserted through lumbar ports,the kidney was liberated partially,and made a small hole,the intrarenal fluid was drawn out.Then the kidney was liberated fully,the renal pedicle were exposed,and blocked with titanium clips or Hem-o-lok and then cut off,the non-functioning kidney was taken out in a specimen bag.Results The 5 operations were successful.The mean operative time was 170 min(150-300 min),and blood loss was 30 ml(10-80 ml).Drainage tube was removed 2-3 days after operation,we have not found any massive hemorrhage,infection,peritoneum rupture,intraabdominal visceral injury,and other severe complications.Conclusion Retroperitoneoscopic nephrectomy for non-functioning kidney with hydronephrosis is proved to be ninimal invasive,safe,effective,and rapid recovery.It would become the first choice for this kind of disease.