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目的:探讨改良的二孔腹腔镜法在肾囊肿开窗术中的运用、推广价值。方法:分析运用改良的二孔腹腔镜法行肾囊肿开窗术患者的临床资料30例。手术方法:取腋中线髂棘上2横指偏腹侧小切口,长约1.5～2.0 cm(a孔),手指内推腹膜,在手指引导下取腋后线12肋缘下(b孔)置0.5 cm套管。0.5 cm套管和1.0 cm套管分别从8号手套食指和中指穿过,和手套一起进入a孔,将手套的手腕部分反盖在a孔周围,予手术皮肤贴膜将手套的手腕部分紧贴在患者腰部皮肤。常规游离肾囊肿表面,行囊肿开窗术,从b孔取出标本,a孔放置引流管。结果:手术时间10～35 min,平均25 min;术后住院2～4天,平均3天。随访时间2～3个月,未出现相关并发症。结论:使用普通的腹腔镜器械进行改良二孔腹腔镜肾囊肿开窗术是安全可行的,伤口美观,效果良好。并且在此熟练的基础上可以同样开展其他后腹腔手术,具有推广运用价值。
Objective: To explore the improved two-hole laparoscopy in renal cyst fenestration in the use and promotion of value. Methods: The clinical data of 30 patients who underwent open two-hole laparoscopy for renal cell cyst fenestration were analyzed. Surgical methods: take the axillary midline iliac spine on the two transverse partial ventral small incision, about 1.5 ~ 2.0 cm (a hole), push the peritoneum inside the finger, under the guidance of the axillary line under the 12 rib margin (b hole) Set 0.5 cm bushing. 0.5 cm bushing and 1.0 cm bushing through the index finger and middle finger of No. 8 glove, respectively, and enter the a hole together with the glove, anti-cover the wrist part of the glove around the a hole and apply the surgical skin foil to hold the wrist part of the glove close to In the patient’s waist skin. Conventional free surface of renal cysts, cysts open fenestration, remove the specimen from the b hole, a hole placed drainage tube. Results: The operation time ranged from 10 to 35 minutes with an average of 25 minutes. The patients were hospitalized for 2 to 4 days with an average of 3 days. Follow-up time of 2 to 3 months, no related complications. Conclusion: It is safe and feasible to use ordinary laparoscopic instruments to improve two-hole laparoscopic renal cysts. It has good wound appearance and good effect. And on the basis of this skilled can also carry out other post-abdominal surgery, with the promotion and use of value.