B超引导下经皮穿刺硬化术与后腹腔镜下去顶术治疗单纯性肾囊肿的比较

Percutaneous aspiration with sclerotherapy versus retroperitoneal laparoscopic deroofing in the management of simple renal cysts

目的 B超引导下肾囊肿经皮穿刺抽液术联合无水乙醇注射硬化术和后腹腔镜下肾囊肿去顶术是目前治疗单纯性肾囊肿的常用方法,文中比较2种术式的疗效、安全性及适用性。方法回顾性分析112例单纯性肾囊肿患者资料,其中55例行B超引导下肾囊肿穿刺术(穿刺硬化组),57例行后腹腔镜下肾囊肿去顶术(腹腔镜组)。比较2组患者的一般情况、病程、症状、肾囊肿位置与大小、手术并发症、住院天数、医疗费用和术后复发率。结果穿刺硬化组患者年龄较腹腔镜组大[(59.7±12.7)岁vs(52.0±12.8)岁,P<0.05];2组肾囊肿病程、伴随症状、单发与多发比例、肾囊肿大小、术后并发症差异无统计学意义(P>0.05);穿刺硬化组肾囊肿位于上极和腹侧面的比例显著低于腹腔镜组(P<0.01);穿刺硬化组患者平均住院日明显短于腹腔镜组[(2.5±1.5)d vs(7.8±3.0)d,P<0.01],平均住院费用也明显低于腹腔镜组[(2003.2±1140.5)元vs(16421.5±2740.8)元,P<0.01]。结论与后腹腔镜下去顶术相比,B超引导下经皮穿刺硬化术具有操作简便、疗效好、并发症少、住院天数短、医疗花费小的特点,是一种值得推广的治疗肾囊肿的方法。但对于位于肾上极或腹侧面的囊肿,后腹腔镜下去顶术具有更大的优势。

Objective Ultrasonography-guided percutaneous aspiration combined with 95% ethanol sclerotherapy and retroperitoneal laparoscopic deroofing are commonly used in the treatment of simple renal cysts.This study was to compared the effect,safety and suitability of the two procedures.Methods We retrospectively analyzed 112 cases of simple renal cysts,55 treated by percutaneous aspiration with sclerotherapy（PAS）,and the other 57 by retroperitoneal laparoscopic deroofing（RLD）.We compared the two groups in the demographic characteristics,course of disease,clinical manifestations,position and size of the cysts,surgical complications,hospital stay,medical costs and recurrence rate.Results The patients of the PAS group were older than those of the RLD group（[59.7±12.7] yr vs [52.0±12.8] yr,P〈0.05）.There were no statistically significant differences in the ratio of single/multiple renal cysts,cysts size and surgical complications between the two groups（P〉0.05）.The RLD group showed significantly more cysts in the ventral surface of the kidney than the PAS group（27.9% vs 3.57%,P〈0.01）,while the hospital stay were significantly shorter and medical costs remarkably lower in the latter than in the former（[2.5±1.5] d vs [7.8±3.0] d,[2003.2±1140.5] yuan vs [16421.5±2740.8] yuan,P〈0.01）.Conclusion PAS is superior to RLD in the management of simple renal cysts for its easy operation,good effect,few complications,short hospital stay and low medical costs,while RLD has more advantages in the treatment of the cysts in the ventral surface of the kidney.