腋前线切口在肥胖患者后腹腔镜肾根治切除术中的应用OACSTPCD

Objective To explore the application skills and clinical value of anterior axillary incision in retroperitoneal laparoscopic radical nephrectomy in obese patients.Methods The clinical data of 49 obese patients who underwent retroperitoneal laparoscopic radical nephrectomy in our hospital from September 2015 to September 2022 were retrospectively analyzed and divided into the modified group(16 cases)and the traditional group(33 cases).Patients in the modified group were routinely placed with 3 Trocars and then added an auxiliary trocar in the front axillary line for surgery.Patients in the traditional group were routinely placed with 3 Trocars for surgery.The surgical conditions and postoperative recovery conditions of patients in the two groups were compared.Results There was no statistically significant difference in the intraoperative blood loss or the measured maximum transverse diameter of the kidney of patients between the two groups(P>0.05).Compared with the traditional group,the operation time,incision length,time to get out of bed,drainage tube indwelling time,postoperative hospital stay in the modified group were shorter/earlier,and the proportion of patients with used postoperative analgesic drugs,abnormal incisional sensation 3 months after surgery,and local muscle swelling at the incision was smaller,and the differences were statistically significant(P<0.05).Conclusion Adding an auxiliary trocar to the anterior axillary line for retroperitoneal laparoscopic radical nephrectomy in obese patients can lock the starting and ending points of the incision,making it easier for assistants to perform auxiliary operations,improve the smoothness of the operation,shorten the operation time,and does not increase surgical complications.Choosing the anterior axillary incision to remove the kidney specimen has the advantages of protecting muscles and nerves,reducing postoperative incision pain and complications,and achieving good healing.