酒精硬化疗法与腹腔镜手术治疗单纯性肾囊肿的比较

Comparison of alcohol sclerotherapy and laparoscopic surgery in patients with simple renal cyst

目的:评估用酒精硬化疗法和腹腔镜手术治疗症状性单纯性肾囊肿的疗效和安全性。方法:选取25例症状性单纯性肾囊肿患者,其中15例患者先给于经皮囊肿穿刺抽吸而后向囊内注射体积分数为99%的酒精,另10例患者采取腹膜后腹腔镜去顶术。所有患者均随访6个月,分别记录和评价两组患者的手术时间、住院天数、住院费用、成功率和并发症的发生率。结果:酒精硬化治疗组和腹膜后腹腔镜肾囊肿去顶组的成功率分别为87%和100%,术后并发症的发生率为13%和20%,但两组在手术成功率和并发症的发生率上无统计学意义。两组的手术时间[(57.0±8.4)min,(94.0±19.0)min]、住院天数[(1.0±0.0)d,(2.5±0.5)d]和住院费用[(5 017.08±90.62)元,(14 698.35±985.76)元]相比,酒精硬化治疗组各指标明显低于腹腔镜手术,具有统计学差异(P<0.01)。结论:酒精硬化治疗因具有操作简单、非侵袭性和有效性高的特点,可作为症状性单纯肾囊肿的主要治疗方法。当酒精硬化治疗失败或酒精硬化治疗穿刺困难时腹腔镜肾囊肿去顶术可作为一种良好的备选方案。

Aim： The aim of this study was to assess the clinical efficacy and safety of alcohol sclerotherapy and laparoscopic surgery for symptomatic simple renal cysts. Methods： Of 25 patients with symptomatic simple renal cyst, 15 patients underwent percutaneous aspiration followed by injection of 99% ethanol and 10 performed retroperitoneal laparoscopic marsupialization. All patients were followed up over a period of 6 months. In both groups, we evaluated operating time, hospital stay, cost, success rate and complication rate. Results： Comparing alcohol sclerotherapy group with retroperitoneal laparoscopic renal cystectomy group, there was no statistical significance in success rate and complication rate （P 〉 0. 05） even though success rates were 87% and 100%, complication rates were 13% and 20%, respectively. However, the operating time [ （57.0 ± 8.4） min, （94.0 ± 19. 0） mini, hospital stay [ （ 1.0 ± 0. 0） day, （2. 5 ±0. 5） day] and cost [ （5017.08 -±90. 62） yuan, （ 14 698.35 ±985.76） yuan] were significantly deceased in the alcohol sclerotherapy group （ P 〈 0. 01 ）. Conclusion： Alcohol sclerotherapy is considered as a primary treatment for symptomatic simple renal cyst because it is simple, noninvasive and highly cost-effective. However, laparoscopic ablation of renal cysts may be indicated as an alterative treatent of patients who have failed alcohol sclerotherapy or expected technical difficulty.