腹腔镜肾囊肿去顶减压术与传统开放手术的对比研究

Comparative study of laparoscopic renal cyst unroofing and decompression with traditional open surgery

目的：总结经腹腹腔镜囊肿去顶减压术治疗单纯性肾囊肿的经验，探讨手术适应证、手术要点及其优点。方法：回顾分析28例肾囊肿患者在全麻下经腹腔途径行腹腔镜囊肿去顶减压术的临床资料。距肾实质3～5mm处用剪刀沿囊肿边缘环形切除囊肿顶壁，用3％碘酊纱条涂擦剩余囊肿壁以破坏残留的囊壁上皮。结果：本组28例手术均获成功，无中转开放手术，手术时间45～80min，平均62min。术中出血20～60ml，平均50ml，术后24～48h拔除引流管，无出血、感染等并发症发生。术后住院4～6d，平均5d。随访6～12个月，无复发病例。结论：腹腔镜肾囊肿去顶减压术是一种安全有效的治疗方法，适用于单纯性肾囊肿，与传统开放手术相比具有患者创伤小，术中出血少，术后痛苦轻，康复快，住院时间短等优点。

Objective：To sum up the experience of transabdominal laparoscopic unroofing and decompression in treatment of simple renal cyst, and discuss operative indication, key point and advantages compared with traditional laparotomy. Methods ：The retro- spective analysis was made on the clinical data of 28 patients who suffered from renal cyst and underwent transabdominal laparoscopic unroofing and decompression under general anesthesia and tracheal intubation. The roof of renal cyst was annularly incised with shears 3-5mm away from the renal parenchyma. The 3% Iodine Tincture gauze was embrocated on remnant cyst wall to destroy its epithelium. Results：All 28 operations were successful without conversion to open surgery. The mean operative time was 62min （range 45-80min）, mean blood loss was 50ml （range 20-60ml）. Drainage tube was extracted 24-48h after operation, no complications such as hemorrhage or infection occurred. Mean postoperative hospital stay was 5d （range 4-6d）. In the follow up of 6-12 months, no recrudesce was found. Conclusions ：The laparoscopic renal cyst unroofing and decompression is a safe and effective treatment for simple renal cyst. Compared with traditional open surgery,it has advantages of less trauma, less intraoperative blood loss, less postoperative pain, quicker recovery and shorter hospital stay.