单孔后腹腔镜和标准后腹腔镜治疗单纯性肾囊肿的对比分析

Comparison of single port retroperitoneal laparoscopy versus standard retroperitoneal laparoscopy for renal cysts

目的 比较单孔后腹腔镜和标准后腹腔镜治疗肾囊肿的安全性及可行性. 方法 收集2010-05 ～2013-05昌平区中西医结合医院诊治的51例单纯性肾囊肿病例,其中单孔经后腹腔镜下治疗18例肾囊肿（单孔组）,应用标准后腹腔镜治疗肾囊肿33例（标准组）.记录患者年龄、囊肿大小、手术时间、估计术中出血量、术中、术后并发症、留置引流管时间、术后住院时间等临床资料,并对结果进行分析. 结果 单孔组和标准组患者肾囊肿平均直径为（6.5±1.6） cm、（5.9±1.6）cm（P=0.03）,两组均未中转开放手术,两组平均手术时间分别为（83±12.1）min和（57±10.1） min（P =0.02）.术中出血量分别为（37±8.2）ml和（30 ±6.4）ml （P=0.71）.术后留置引流管时间为（2.0±0.5）d和（1.5±0.5）d（P=0.33）,术后平均住院时间分别为（6.8±1.2）d和（6.0±1.0）d（P=0.64）,术中均未发生严重并发症.术后随访6月,均未见囊肿复发. 结论 单孔后腹腔镜法和标准后腹腔镜法治疗肾囊肿比较,体表美容效果较好,但手术难度加大,手术时间明显较长.

Objective To compare the safety and feasibility of single port retroperitoneal laparoscopy versus standard retroperitoneal laparoscopy for renal cysts.Methods Eighteen cases of renal cysts were treated with single port retroperitoneal laparoscopy from May 2010 to May 2013.Thirty-three cases of rental cysts were treated with standard retroperitoneal laparoscopy from May 2010 to May 2013.The clinical data,including age,cyst size,operation duration,estimated blood loss,intra-operative and post-operative complications,drainage duration and postoperative hospital stays were recorded and compared between two groups.Results The average diameter of renal cysts was （6.5 ± 1.6） cm in single port group and （5.9 ± 1.6） cm in standard group （P =0.03）.No conversion-to-open surgery happened in two groups.The operation duration was （83 ± 12.1）min in single port group and （57 ± 10.1）min in standard group（P =0.02）.The blood loss volume was （37 ± 8.2） ml in single port group and （30 ± 6.4） ml in standard group （P =0.71）.The drainage duration was （2.0 ± 0.5） d in single port group and （1.5 ± 0.5） d in standard group （P =0.33）.The post-operative hospital stay was （6.8 ± 1.2）d in single port group and （6.0 ± 1.0）d in standard group（P =0.64）.No serious postoperative complications happened in two groups.During the 6 months postoperative follow up,no cyst reoccurred.Conclusion Single port retroperitoneal laparoscopy has better effect in body surface than the standard retroperitoneal laparoscopy,but it is more difficult to operate and lasts much longer time.