单孔经脐腹腔镜下肾盂旁囊肿切除术11例报告

Laparoendoscopic single-site decortication of peripelvic renal cyst: a report of 11 cases

目的 探讨单孔经脐入路腹腔镜下肾盂旁囊肿切除术的可行性及安全性。方法 2011年10月-2013年12月,经脐入路实施单孔腹腔镜下肾盂旁囊肿切除术11例。其中,男6例,女5例;年龄21～60岁,平均43.4岁。均表现为不同程度的患侧腰或腹部疼痛,其中1名患者曾行囊肿穿刺吸引术后复发。结果 11例手术均顺利完成,无中转传统腹腔镜或开放手术。平均手术时间113（85～172）min,平均估计失血量35（20～85）ml,术后平均住院时间3（2～5）d。无严重术中或术后并发症发生,仅1例患者术后第1天出现短暂的发热,经抗生素治疗后体温恢复正常。术后随访3～25个月,平均11个月,影像学检查均未发现囊肿复发。结论 对于手术经验丰富的术者,单孔经脐入路腹腔镜下肾盂旁囊肿切除术安全、可行,但仍需要进一步的研究以评估其技术局限性和相对传统腹腔镜手术的优势。

【Objective】This study aimed to evaluate the safety and feasibility of transumbilical LESS for symptomatic peripelvic cysts. 【Methods】 Between October 2011 and August 2013, 11 patients with symptomatic peripelvic renal cysts underwent transumbilical LESS decortication. 6 were males and 5 were females. The age of the patients ranged from 21 to 60 years（mean=43.4 years）. All patients presented with chronic flank or abdominal pain,and one had previously undergone unsuccessful cyst aspiration.【Results】Transumbilical LESS for a peripelvic cyst was successfully accomplished in all patients, with no conversion to traditional laparoscopy or open surgery. The mean operative time was 113 minutes（range 85~172）. Mean estimated blood loss was 35 ml（range 20~85）. The mean hospital stay was 3 days（range 2-5）. There were no major complications, the only minor complication was one case of transient postoperative fever, which resolved with appropriate antibiotic therapy. The average follow-up was11 months（range 3~25）. All cases had no recurrence according to the most recent computed tomography findings.【Conclusion】In experienced hands, transumbilical LESS peripelvic cyst decortication is feasible and safe. But additional studies are needed to further evaluate its technical limitations and potential benefits compared with traditional laparoscopy.