腹腔镜肾囊肿去顶术的临床应用

Clinical application of laparoscopic renal cyst unroofing

目的评估腹腔镜肾囊肿去顶术的可行性和临床应用价值。方法设腔镜组(30例)和对照组(开放手术组,12例),术前经CT检查,必要时加行IVU明确诊断为肾囊肿。腔镜组中经腹膜后途径28例,其中10例对C点的定位作了改进;经腹腔途径2例。结果腔镜组均经术后随访半年至3年原病灶均未复发,无切口延迟愈合等并发症。手术时间平均80min,平均住院周期5.35d,平均术后下床时间16h,而对照组则分别为70min、8.5d和72h,显示腔镜组比对照组有明显进步(P<0.05)。结论与传统开放性手术相比,腹腔镜肾囊肿去顶术具有创伤小、出血少、住院周期短等优点,易掌握,并发症几乎不发生,可代替开放性术式。

[Objective] To evaluate the feasibility and value of clinical application of laparoscopic resection of renal cyst. [Methods] The case group （endoscopic, 30 cases） and control group （open-operatic,12 cases）, those were examined by CT, and IVU if necessary, were established. Renal cyst was all diagnosed for them. The way through the retroperitoneum was adopted in 28 cases, in 10/28 the location of the point C was improved and other one through the peritoneum in 2 cases. [Results] The primary focuses on endoscopic group are followed up for 1/2 to 3 years after operation, and not repeated. The mean of the operation time was 80 minutes and the hospitalized period averaged 5.35 days. Mean ambulatory day was 16 hours. It has no complications. The data showed marked advance over the control group （P 〈0.05）. [Conclusion] Laparoscopic resection of renal cyst possesses many advantages including less wound, less bleeding, shorter hospitalized period, being mastered easier and fewer complication etc, than the traditional open operations.