后腹腔镜术切除介入治疗后复发肾囊肿35例报告

Transretroperitoneal laparoscopy for recurrent renal cysts after interventional treatment:Report of 35 cases

目的：探讨采用后腹腔镜囊肿去顶切除术治疗介入治疗后复发的。肾囊肿的疗效。方法：2002年5月～2012年3月采用后腹腔镜囊肿去顶切除术治疗介入治疗后复发的肾囊肿患者35例，每例至少1枚囊肿超过4cm，囊肿最大径12cm。具体方法是在后腹腔镜直视下用电凝刀切穿囊壁5mm，用吸引器吸尽浑浊不清囊液，再用生理盐水冲洗干净，用超声刀扩大剪开囊壁，距正常肾实质约0．8cm处环形切除囊壁，切口边缘同时电凝止血，常规放置F22～26引流管。结果：35例手术时间30～80min，平均45min。出血量10～50ml，平均18ml。抽吸囊液量50～900ml，平均约180ml。术后平均住院3．8天（3～5天）。随访3～60个月，经B超复查，切除的囊肿未见复发。结论：对介入治疗后复发的肾囊肿采用经后腹腔镜手术切除疗效确切。

Objective：To explore the efficacy of transretroperitoneal laparoscopy for recurrent renal cysts with sclerotherapy. Methods：From May 2002 to March 2012, we retrospectively analyzed 35 cases of the recurrent renal cysts diameter 4-12 cm which had been interventional treatment by anhydrous ethanol injection for 3 to 12 months. Transretroperitoneal laparoscopy identified and separated the cyst which the surface uneven fat adhesions, and then cut the cyst 5 mm and sucked the turbid liquid out and saline flush repeatedly. To inspect the lesions within the cyst, we enlarged the incision on the surface of the cyst, and then cut the cyst at 0.8 cm away from the renal parenchyma and coagulation with ultrasonic scalpel. Place Fe22-26 drainage tube for every patients. Results：The pro-cedure was completed successfully in 35 cases. The mean operation time was 45 min（30-80）, and mean blood loss was 18 m1（10-50 ml） and the sucked liquid was 180m1（50-900 ml）. The patients resumed of Pbed activities in 24 to 48 hours after the operation, and drainage tube and urinary catheter were removed in 1 to 4 days. The mean hospi- tal stay was 3.8 days（3-5）. The patients achieved a follow-up for 3 to 60 months with a mean of 24 months, during which, all the patients were improved without recurrence. Conclusions：Transretroperitoneal laparoscopy is ef- fective for recurrent renal cysts with interventional treatment.