后腹腔镜与开放性肾囊肿去顶术治疗肾囊肿和多囊肾的对比研究

Comparative study on retroperitoneal laparoscopy and open renal cyst unroofing in the treatment of simple renal cysts and polycystic kidney

目的比较后腹腔镜和开放性肾囊肿去顶术治疗单纯性肾囊肿及成人型多囊肾的优越性,探讨后腹腔镜肾囊肿去顶术的适应证。方法回顾性分析采用后腹腔镜行肾囊肿去顶术治疗单纯性肾囊肿26例(A1组)、成人型多囊肾8例(B1组),及采用肾囊肿去顶术治疗29例单纯性肾囊肿(A2组)及10例成人型多囊肾(B2组)的临床资料。结果两种手术方式治疗单纯性肾囊肿及成人型多囊肾的疗效相当;后腹腔镜组(A1组、B1组)在手术时间、术中出血、术中术后并发症、术后下床活动时间、术后镇痛药使用情况、留置引流管的时间、禁食时间、术后住院时间、复发率方面优于开放性手术组(A2组、B2组)(P<0.01)。结论后腹腔镜肾囊肿去顶术明显优于开放性肾囊肿去顶术,可作为单纯性肾囊肿及成人型多囊肾外科治疗的首选。

Objective To compare the advantage of retroperitoneal laparoscopy and open renal cyst unroofing in treatment of simple renal cysts and adult polycystic kidney, and to investigate the indications of retroperitoneal laparoseopy renal cyst unroofing. Methods Clinical data of renal cyst unroofing of 26 simple renal cysts cases （ Group A1 ） and 8 adult polycystie kindncy disease（ ADPKD）cases （ Group B1 ） by using retroperitoneal laparoscopy ,and 29 cases simple renal cysts （Group.A2） and 10 cases ADPKD（ Group B2） by open renal cyst unroofing were retrospectively analyzed. Results Both methods could get similar effect in the treatment of simple renal cysts and ADPKD. The operation time,the intraoperative bleeding volume, the complications during and after operation, the postoperative activity out of bed , the postoperative painkill- er used,tbe indwelling drainage tube time,the fasting time,the postoperative hospital stay and the reduction rate of the retro- peritoneal laparoscopy group（ Group A1 and Group B1 ） were better than those of the open surgical group （ Group A2 and Group B2） （ P 〈 0.01 ）. Conclusion Retroperitoneal laparoscopy renal cyst unroofing were superior to open renal cyst unroofing,suggesting it as the first choice in surgical treatment for simple renal cysts and ADPKD.