后腹腔镜和开放去顶减压术治疗多囊肾的疗效比较

A comparison of the clinical outcome between retroperitoneal laparoscopic and open cyst decortication for autosomal dominant polycystic kidney disease

目的:通过与传统开放肾囊肿去顶减压术治疗常染色体显性遗传性多囊肾病(ADPKD)的效果比较,评价后腹腔镜肾囊肿去顶减压术治疗ADPKD的临床价值。方法:回顾性分析后腹腔镜肾囊肿去顶减压术治疗ADPKD25例(A组)及开放肾囊肿去顶减压术29例(B组)的临床资料.就两组手术时间、术中出血量、术后肠道功能恢复时间、术后止疼药用量、术后住院天数、并发症和临床疗效等指标进行比较,根据数据类型选用χ2检验、成组t检验或Mann-WhiteyU检验。结果:A组在术中出血量、术后肠道功能恢复时间、术后止疼药用量、术后住院天数方面优于B组,差异有统计学意义(P<0.01);并发症和临床疗效等指标与B组相当,差异无统计学意义(P>0.05)。结论:后腹腔镜肾囊肿去顶减压术是治疗ADPKD微创、安全、有效的疗法。

Objective：To assess the clinical value of retroperitoneal laparoscopic cyst decortication as compared and open cyst decortication for autosomal dominant polycystic kidney disease. Methods： The clinical data （demographic, intraoperative, postoperative and midterm follow up data）for 25 patients who underwent retroperitoheal laparoscopic cyst decortication were retrospectively compared with those for 29 patients who underwent open cyst decortication through a retroperitoneal flank. Approach： Student-test,Pearson chi square test and Mann-Whitey rank sum test were applied for statistical analysis as appropriate. Statistical significance was defined as P〈0.05. Results：Patient demographics were similar between the two groups. In group A, operation time, estimated blood loss,recovery of intestinal function, analgesic requirements, postoperative length of hospital stay are better than those in group B（P〈0.01）. No intraoperative complications occurred in either group. Incidence of postoperative complications and clinical outcome are equivalent in group A and B（P〉0.05）. Conclusions： Retroperitoneal laparo scopic cyst decortication is a minimally invasive, safe and effective therapy for autosomal dominant polycystic kid ney disease.