两种途径进行腹腔镜去顶减压术治疗肾囊肿的疗效观察

Curative effects of two hardening agents in treating renal cysts unroofing by laparoscopy

目的探讨经腹膜后途径与经腹腔途径行腹腔镜肾囊肿去顶减压术治疗肾囊肿的临床疗效与安全性。方法将单纯性肾囊肿患者85例按照入院先后随机分为经腹膜后途径组(治疗组42例)与经腹腔途径组(对照组43例)。两组患者均在全麻下应用标准腹腔镜(3孔法)治疗。记录患者囊肿大小、手术时间、术中出血量、并发症(术中及术后)、引流管引流时间、术后24h疼痛指数、术后住院时间及住院费用等临床资料,对结果进行分析。结果两组患者均顺利完成手术,无中转开腹。与对照组比较,治疗组手术时间短,差异有统计学意义(P<0.05);术中出血量、术后24 h疼痛指数评分、住院时间、住院费比较,差异无统计学意义;术中及术后未发生严重并发症;术后引流管留置时间均为36 h。结论腹腔镜去顶减压术治疗肾囊肿安全可行,经腹膜后途径更适合于临床要求,可优先考虑。

Objective To compare the clinical effects and safety of laparoscopy in treating renal cysts unroofing. Methods Eighty-five patients were divided into the retroperitoneal route （treat- ment group 42 cases） and the peritoneal route （control group 43 cases）. Treat all patients by conventional laparoscopy surgery （three site） respectively. The date of cyst size, operative du- ration, estimated blood loss, complications （intra and post-operative）, drainage duration, post- operative pain score after 24 h visual analogue scale, post-operative hospital stay and the cost were recorded and analyzed. Results Compared with the control group, the operative duration in treatment group was decreased （P 〈0.05）. Estimated blood volume, visual analogue scale score, post-operative hospital stay and the cost had no significant difference. The drainage duration was 36 h for both groups. There was no severe intra-ope,＇ativc complication in both groups, and postoperative intestinal recovery was slow in control group. The cost was not significantly different. Conclusion The renal cysts unroofing by laparoscopy is a safe and feasible option for the treatment of renal cysts. The retroperitoneal route is suitable for clinical and can be applied in renal cysts unroofing by laparoscopy.