目的评价后腹腔镜下肾肿瘤根治性切除术的安全性及疗效。方法后腹腔镜下行肾根治性切除术21例,其中肾癌19例,肾盂癌1例,上段输尿管癌1例。对手术过程进行总结,术后疗效进行随访观察。结果21例手术均获成功。术中腹膜破裂共7例,其中采用改良逆行分离肾周脂肪囊与腹膜间隙方法的14例中,仅2例发生腹膜破裂。所有患者术后随访1~16个月,平均7个月,均无瘤生存。结论早期肾癌行后腹腔镜下肾癌根治术安全可靠,手术层次清晰,疗效良好,逆行分离肾周脂肪囊与腹膜间隙可以避免腹膜破裂。 Objective To evaluate the safety and efficacy of retroperitoneal laparoscopic radical nephrectomy. Methods Laparoscopic radical nephrectomy in 21 cases, including 19 cases of renal cell carcinoma, renal pelvis cancer in 1 case, upper ureteral carcinoma in 1 case. To summarize the surgical procedure, follow-up observation of postoperative efficacy. Results 21 cases were successful. Intraoperative peritoneal rupture in a total of 7 cases, of which the use of retrograde separation of perirenal fat balloon and peritoneal space method of 14 cases, only 2 cases of peritoneal rupture. All patients were followed up 1 to 16 months, an average of 7 months, no tumor-free survival. Conclusions The postoperative laparoscopic radical nephrectomy is safe and reliable, the operation level is clear and the curative effect is good. The peritoneal rupture can be avoided by retrograde separation of perirenal adipose capsule and peritoneal space.