钬激光切开内引流与后腹腔镜囊肿去顶术治疗肾盂旁囊肿患者疗效比较

Comparison of holmium laser ureteroscopic intrapelvic drainage vs. retroperitoneal laparoscopy forthe treatment of peripelvlc cyst

目的探讨输尿管镜钬激光切开内引流术治疗肾盂旁囊肿的疗效，并与后腹腔镜肾盂旁囊肿去顶术比较。方法治疗肾盂旁囊肿患者48例，随机分成两组，分别行输尿管镜钬激光切开内引流术（A组，25例）和后腹腔镜肾盂旁囊肿去顶术（B组，23例）。比较两组手术时间、术中出血量、肠道恢复时间及住院时间等。结果A、B两组的手术时间分别为（24．12±4．51）和（69．48±14．21）min，差异有统计学意义（P〈0．05）；术中出血量分别为（10．24±3．38）和（49．35±12．18）rnl，差异有统计学意义（P〈0．05）；肠道恢复时间分别为（13．24±2．39）和（31．43±6．99）h，差异有统计学意义（P〈0．05）；住院时间分别为（3．24±1．42）和（6．04±1．29）d，差异有统计学意义（P〈0．05）。48例患者术后恢复顺利。随访6-24个月，A、B两组各有2例复发，差异无统计学意义（P〉0．05）。结论与后腹腔镜囊肿去顶术比较，经尿道输尿管镜下钬激光切开内引流术治疗’肾盂旁囊肿具有创伤小、恢复快等优点。

Objective To evaluate the clinical efficacy of holmium laser ureteroscopic intrapelvic drainage for the treatment of peripelvic cyst and to compare this technique with retroperitoneal laparoscopic renal cyst unroofing. Methods From January 2009 to December 2012, a total of 48 patients with peripel vic cysts were treated. The patients were divided into two groups randomly. The patients in group A were treated by Holmium laser ureteroscopic endo-decortication （ n = 25 ） , and those in group B by retroperitoneal laparoscopic unroofing （n = 23 ）. The operative time, intraoperative blood loss, success rate, postoperative intestinal recovery and hospital stay were compared between the 2 groups. The recurrence rate was compared during the follow-up period. Results In groups A and B, the operative time was （24. 12 ± 4. 51 ） vs. （69.48 ± 14. 21 ） rain （P 〈 0. 05 ） ; intraoperative blood loss was （ 10. 24 ± 3. 38 ） vs. （49. 35 ± 12. 18 ） ml （ P 〈 O. 05） ; intestinal recovery time was （ 13.24 ±2. 39） vs. （31.43 ± 6. 99） h （P 〈 0. 05 ） ; hospital stay was （3.24 ± 1.42） vs. （6.04 ± 1.29） days （ P 〈 0.05 ）, respectively. All the patients recovered smoothly. During the follow-up period of 6-24 months, 2 cases had recurrence in each of both groups （P 〉 0. 05）. Con clusion Holmium laser ureteroscopic intrapelvic drainage for the treatment of peripelvlc cyst has the advan tage of mini-invasion and rapid recovery in comparison with retroperitoneal laparoscopic unroofing.