腹腔镜肾囊肿去顶减压术治疗多囊肾的临床分析

Clinical analysis of retroperitoneal laparoscopic cyst decortication in polycystic kidney

目的 探讨后腹膜腹腔镜下去顶减压术（retroperitoneallaparoscopic cyst decompression,LRCD）治疗常染色体显性遗传性多囊肾病的方法（autosomal dominant polycystic kidney disease,ADPKD）及疗效。方法 总结后腹膜腹腔镜下去顶减压术治疗ADPKD患者20例,对手术天数、术后平均引流量、手术前后肾功能、及血压情况进行分析。结果 术后随访3～18个月,患者肾功能改善,,血压值kPa改善,手术前后对比有统计学意义（P〈0.05）,B超、CT均未发现囊肿复发。结论 后腹膜腹腔镜下去顶减压术治疗常染色体显性遗传性多囊肾病手术创伤小、术中出血少、术后恢复快、疗效可靠,是一种比较积极可行的手术方法。

Objective To discuss method and effect of retroperitoneal laparoscopic cyst decortication in autosomal dominant polycystic kidney disease （ADPKD）. Methods Twenty cases （15men, 5women） of ADPKD from July 2002 to April 2006, performed with retroperitoneal laparoscopic cyst decortication were enrolled to analyze indexes such as mean operating time, loss of blood, postoperative hospital stay, drainage, renal function before and after operation, and blood pressure with SPSS for statistical test. Results All operations succeeded, with an average operative time of 80 min, without any main complications. Average postoperative hospital stay was 6.9days, all patients underwent follow-up after discharge, with notable pain relief afterwards. Blood pressure was 16- 18/10.7- 12.7 kPa and renal function improved. Improvements of BP, Cr and BUN were all of statistical significances （ P 〈 0.05）. Conclusion Retroperitoneal laparoscopic cyst decortication in ADPKD is feasible and effective with microstart in operation, but up to now, as long-term, large samples and follow-up studies are still lacking, further research will be required. According to our experiments, it is suggested that the remnants of kidney should be kept as much as pissible during operation in order to help to recover of renal function.