腹腔镜手术治疗肾盂旁囊肿的体会(附67例报告)

Clinical Experience of Laparoscopic Surgery in the Treatment of Parapelvic Cyst (report of 67 cases)

目的：探讨腹腔镜技术治疗肾盂旁囊肿的方法和疗效，并结合治疗体会，为临床提供更多的参考依据。方法：对2006年3月～2011年9月我科收治的67例肾盂旁囊肿患者的临床资料进行回顾性分析，其中采用经腹膜后途径29例，经腹腔途径20例，单孔腹腔镜技术18例。分析患者的手术时间、术中出血量、并发症的发生情况、术后住院时间及复查随访情况。结果：所有病例的手术均成功，手术时间38～120min，平均时间（70．3±9）min；术中出血量10～125ml，平均（47．3±15．7）ml；均未出现肾蒂及肾盂损伤等并发症。术后2～6天（平均3．4天）拔除引流管，术后住院3～7d，平均（4．2±0．6）d。术后1月复查，腰酸、腰痛、镜下血尿以及肾积水、高血压等临床症状均消失。术后随访1～47个月，未见囊肿复发。结论：腹腔镜手术治疗肾盂旁囊肿具有暴露充分、创伤小、出血少、恢复快等优点，可作为肾盂旁囊肿治疗的首选方法。术者应严格掌握其适应症，术前完善相关检查，术中仔细辨认肾静脉壁与囊肿，操作轻柔，填入肾门脂肪可有效防止囊肿的术后复发。

Objective： To Investigate the method and effect of laparoscopic surgery in the treatment Parapelvic cyst, summarize the experience of treatment and provide references for the clinic. Methods： A retrospective research was performed to analyze the clinical data of 67 cases of Parapelvic cyst who were admitted in our hospital from March 2006 to September 2011, including 29 cases of laparoscopic retroperitoneal approach, 20 cases of abdominal approach, 18 cases of bytransumbilical single-port laparoscopy approach. The operating time, blood loss, complications, postoperative hospital stay and follow-up were recorded and reviewed. Results： All the patients were successfully treated. The mean operating time was （70.3＋ 9.8） rain（range of 38-120rain）. The mean blood loss was （47.3±15.7） ml （range of 10-125 ml）, and no renal pelvis and renal pedicle injury. Postoperative hospital stay was 3-7 d, the average was （4.2± 0.6） d. Patients were followed up 2 to 37 months, no cyst recurrence was found. Conclusion： Laparoscopic surgery had the advantages of thorough exposure, less trauma and bleeding, faster recovery, which could be used as the preferred treatment in the reatment ofparapelvic cyst. The operator should strictly control the indications, complete related examination before surgery, distinguish the renal vein wall with hydatoncus during surgery in order to effectively prevent the relapse ofhvdatoncus after surgery.