经腹膜后腹腔镜囊肿去顶术治疗肾囊肿35例临床体会

Experience of retroperitoneoscopic unroofing for treating renal cyst in 35 cases

目的探讨经腹膜后腹腔镜囊肿去顶术治疗单纯肾囊肿的疗效,并讨论手术适应症和手术要点。方法对我科在2005年10月～2010年9月采用经腹膜后腹腔镜囊肿去顶术治疗肾囊肿35例的临床资料进行回顾性分析。结果 32例手术成功,术中出血量50～250ml(平均80ml),平均住院时间为7d。在手术开展早期有3例中转开放手术,其中1例膈肌损伤,2例腹膜损伤,技术熟练后无并发症发生。所有患者随访6个月,仅有1例复发。术后恢复快。结论经腹膜后腹腔镜囊肿去顶术具有安全、疗效好、创伤小、恢复快的优点,宜作为单纯性肾囊肿外科治疗的首选术式。

Objective To investigate the efficacy of transretroperitoneal laparoscopic unroofing in the treatment of renal cyst and to discuss the indication and operation key point. Methods From October 2005 to Sepember 2010,the clinical data of thirty-five cases with renal cyst received transretroperitoneal laparoscopic unroofing were analyzed retrospectively. Results Operations were performed successfully in 32 cases.The volumes of intraoperative bleeding were in 50 to 250 ml （average 80 ml）.The operative time was in 60-150 min （average 85 min）. In the early stage of developmental surgery, 3 cases were converted to open surgery because of 1 case with diaphragmatic injury and 2 cases with peritoneum rupture during operation. No complications occurred after skill of laparoscopic technique. One case recurrence was found 3 months after operation. Conclusion Transretroperitoneal laparoscopic unroofing possesses safe, effective, less trauma and quick recovery ect advantages. It is a first choice for the treatment of simple renal cyst.