局部腹膜切开在腹膜后腹腔镜手术治疗肾囊肿中的应用(附19例报告)

Local peritoneal incision in retroperitoneal laparoscopic treatment of renal cyst:with a report of 19 cases

目的:探讨局部腹膜切开在腹膜后腹腔镜肾囊肿去顶减压术后防止囊肿复发的临床价值。方法:2007年1月至2009年1月为19例肾脏上极或腹侧部单纯囊肿患者行腹膜后腹腔镜肾囊肿去顶减压术,并在囊肿切除后行对应囊肿部位局部腹膜切开。结果:19例手术均获成功,患者术后无腹痛、腹胀等腹部不适症状,未影响肠蠕动。随访1年无囊肿复发及肠疝形成。结论:应用腹膜后腹腔镜治疗肾囊肿减少了患者的痛苦,缩短了住院时间,但部分位于肾脏上极或腹侧部的肾囊肿由于术后局部腹膜的覆盖而再形成囊腔,发生复发或形成囊腔内积液。局部切开囊肿对应的腹膜避免了囊腔的形成,防止了术后复发。

Objective：The aim of this study is to investigate the clinical value of local peritoneal incision in retroperitoneal laparoscopic operation for renal cyst to prevent recurrence. Methods：From Jan.2007 to Jan.2009,19 patients who suffered from renal cyst at upper pole or ventral side underwent laparoscopic renal cyst unroofing and decompression.The corresponding part of the local peritoneum was excised. Results：All operations were carried out successfully,without postoperative abdominal pain,distension or other abdominal symptoms,and the bowel function was normal.During 1 year follow-up,no cyst recurrence or bowel herniation occurred. Conclusions：The retroperitoneal laparoscopic treatment of renal cysts reduces the suffering of patients and hospital stay.However,recurrence or hydrops may occur in some cysts at the upper pole or ventral side of kidney because of local coverage by peritoneum.The incision of corresponding peritoneum can avoid the formation of cyst and prevent recurrence.