[1]卢小刚,代远斌.腹腔镜腰交感神经节切除术的解剖学基础及临床应用[J].第三军医大学学报,2007,29(11):1116-1119.
 LU Xiao-gang,DAI Yuan-bin.Anatomic study for retroperitoneoscopic lumbar sympathectomy[J].J Third Mil Med Univ,2007,29(11):1116-1119.
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腹腔镜腰交感神经节切除术的解剖学基础及临床应用
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
29卷
期数:
2007年第11期
页码:
1116-1119
栏目:
论著
出版日期:
2007-06-15

文章信息/Info

Title:
Anatomic study for retroperitoneoscopic lumbar sympathectomy
作者:
卢小刚 代远斌
重庆医科大学附属第一医院普通外科,重庆市普通外科重点实验室
Author(s):
LU Xiao-gang DAI Yuan-bin
Department of General Surgery, The First Affiliated Hospital, Chongqing Medical  University, Chongqing 400016, China
关键词:
腰交感神经节切除术腹腔镜解剖学
Keywords:
lumbar sympathectomy laparoscope anatomy
分类号:
R323.33; R572; R651.3
文献标志码:
A
摘要:
目的    研究腰交感神经的局部解剖关系,为临床开展腹腔镜腰交感神经节切除术(VALLS)提供解剖学资料。    方法    观察总结成人尸体128侧的腰部交感神经及其毗邻结构的解剖关系;回顾性分析21例VALLS。    结果    ①腰交感神经节数目每侧1~6个不等,以3~4个最多见,位置、形态变异较大。②128侧中发现腰交感干节间支的分裂有12侧,占9.38%。③腰动脉均位于神经干的深面,腰静脉多位于腰交感干浅面,占68.42%。④生殖股神经穿出腰大肌平面多数与L2~L4椎体或椎间盘对齐,穿出点距腰大肌内侧缘(0.81±0.48)cm。⑤输尿管髂血管交界处距腰大肌外缘距离:左侧为(3.36±0.59)cm,右侧为(3.41±0.59)cm。⑥本组21例VALLS手术时间2~3.5 h,术中出血50~80 ml,术中术后未出现严重并发症,手术效果良好。    结论    腹腔镜腰交感神经节切除术成功的关键是掌握良好的腹腔镜操作技巧,熟悉腰交感神经的局部解剖关系,术中认真仔细的操作。
Abstract:
Objective    To research regional anatomy of lumbar sympathetic trunk and provide anatomic information for video-assisted laparoscopic lumbar sympathectomy (VALLS).     Methods    Lumbar sympathetic trunk and its neighboring anatomic relation in 128 sides of adult cadavers and 21 clinic VALLS were retrospectively reviewed.     Results    ① The location, shape and number of the sympathetic ganglia were quite variable. There was 1 to 6 in number unilaterally. ② Lumbar sympathetic trunks of 12 sides in 128 sides were found dividing into 2-3 branches at the distal part. ③ Lumbar arteries were all located under the lumbar sympathetic trunk and the lumbar veins consisting 68.42% situated superficially to the trunk. ④ Genitofemoral nerve pierced the psoas muscle at the level of 2nd to 4th vertebrate or its intervertebral disc. It was only (0.81±0.48) cm away from the medial rim of the psoas muscle. ⑤ Distance between ureter-iliac vessel junction and the lateral rim of the psoas muscle was (3.36±0.59) cm at left side and (3.41±0.59) cm at right side. The operation time was 2-3.5 hours and the intraoperative blood loss was 50-80 ml. There were no severe complications and the effects were satisfying.      Conclusion    Because of great variants and complex neighboring anatomic relation of lumbar sympathic nerve, the critical factor of successful microinvasive VALLS is to grasp the laparoscopic operation skill and anatomy of retroperitoneal space (especially the regional anatomy of lumbar sympathetic trunk) and carefully operating.

参考文献/References:

卢小刚, 代远斌. 腹腔镜腰交感神经节切除术的解剖学基础及临床应用[J]. 第三军医大学学报, 2007, 29(11):1116-1119.

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更新日期/Last Update: 2008-10-23