目的:探讨腹膜后腹腔镜手术治疗肾盂癌、输尿管癌的手术方法及临床经验.方法:回顾分析为13例患者行腹膜后腹腔镜手术的临床资料,其中肾盂癌8例,输尿管癌5例；上段1例,中段2例,下段2例,右侧9例,左侧4例.结果:13例手术均获成功,无一例中转开放.手术时间150 ～ 230 min,平均(160±13.5) min;术中出血量50～160 ml,平均(102±23) ml,无一例输血；术后1～3d恢复排气并进食,2d后下床活动.术后住院7～12d,平均9d.术后定期丝裂霉素间断膀胱灌注,随访3 ～12个月,均无复发、转移及切口种植.结论:腹膜后腹腔镜手术治疗肾盂癌、输尿管癌具有手术损伤小、康复快等优点,且不增加肿瘤种植的风险,与传统开放手术及其他术式相比,术中出血少、手术时间短、术后并发症少.%Objective: To explore the techniques and clinical experience of retroperitoneal laparoscopic operations in the treatment of of renal pelvis and ureteral carcinoma. Methods: Retrospective analysis of 13 cases who underwent laparoscopic nephroureterectomy was conducted. Of which,8 cases were renal pelvis carcinoma and 5 cases were ureteral carcinoma; 1 case was carcinoma of superior segment,2 cases were carcinoma of middle segment and 2 cases were carcinoma of distal segment,9 cases were rightward carcinoma and 4 cases were lefttward carcinoma. Results: All operations were successful without converting to open surgery. The operating time was 150-230 min.mean (160 ± 13.5) min. The blood loss was 50-160 ml,mean (102 ±23) ml,without blood transfusion. The exhaust time was 1-3 d. Patients done ambulation 2 d post operation. The hospital stay time was 7-12 d (mean 9 d). All cases were treated with bladder instillation of mitomycin at regular intervals post operation. No recurrence, metastasis and incision implantation occurred during 3-12 month follow-up. Conclusions: Retroperitoneal laparoscopic nephroureterectomy for the treatment of renal pelvis and ureteral carcinoma is less traumatic with rapid recovery and does not increase the risk of implantation metastasis. Compared with open surgery and other procedures, it has less blood loss, shorter operation time and less complication.
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