腹腔镜下肾囊肿去顶减压术(附139例报告)

LAPAROSCOPIC DECORTICATION OF RENAL CYST:A REPORT OF 139 CASES

目的探讨腹腔镜下经腹腔、后腹腔肾囊肿去顶减压术的治疗方法及疗效。方法采用腹腔镜下肾囊肿去顶减压术治疗单纯性肾囊肿病人139例。在全麻下用自制气囊建立腹膜腔或后腹膜腔途径,腹腔镜下找到并暴露肾囊肿,用超声刀距离肾实质3～5 mm切除囊壁。结果 139例手术均成功,无中转开放手术,无严重并发症发生。手术时间35～130 min,平均57 min。术中出血量10～60 mL,平均32 mL。术后1～2 d拔除引流管,无出血及感染等并发症。术后住院4～8 d,平均5.3 d。术后随访3～24个月,平均13个月,7例复发。结论腹腔镜下肾囊肿去顶减压术具有多种优点,是一种安全有效的治疗方法,临床上可以根据不同的囊肿采取不同的手术入路,是外科治疗肾囊肿的理想术式。

Objective To explore the procedures and efficacy of transperitoneal and retroperitoneal laparoscopic unroofing of renal cyst. Methods Laparoscopic unroofing was undertaken in 139 patients with simple renal cyst under general anesthesia.A self-made air bag was used to create transperitoneal or retroperitoneal approach,the cyst was identified,and the capsule wall removed,3-5 mm from the edge of the renal parenchyma,by using ultrasound knife. Results The laparoscopic procedures were successful in all patients.No conversion to open surgery was required,no severe complications were met.The mean（range） duration of the procedure was 57（35-130） min.The mean（range） of blood loss was 32（10-60）mL.The drainage tube was pulled out 1-2 days after operation without bleeding or infection.The mean（range） hospital stay was 5.3（4-8） days.A mean（range） follow-up of 13（3-24） months was conducted,seven recurrent cases found. Conclusion Laparoscopic deroofing for renal cyst is of many advantages,safe and effective,which is an ideal procedure.Clinically,different approaches can be used based on different conditions.