单孔后腹腔镜与常规后腹腔镜肾囊肿去顶减压术的临床疗效比较

Unroofing of renal cysts under laparoendoscopic single-site and standard laparoscopy

目的：比较单孔腹腔镜和传统腹腔镜经后腹腔途径治疗肾囊肿的临床疗效和安全性。方法：选取122例肾囊肿患者,根据治疗方式的不同将其分为观察组（54例）和对照组（68例）。观察组采用单孔后腹腔镜治疗,对照组采用常规后腹腔镜治疗,比较两组患者平均手术时间、平均出血量、平均卧床时间、疼痛模拟评分以及疤痕长度等。结果：122例患者均完成腹腔镜下手术,无中转手术,无严重并发症。观察组在平均出血量、平均卧床时间、疼痛模拟评分及瘢痕长度等方面均优于对照组,其差异有统计学意义（t=5.597,t=12.365,t=4.236,t=7.371;P〈0.05）,而观察组的平均手术时间长于对照组,差异有统计学意义（t=6.325,P〈0.05）。术后随访3-6个月,两组患者均未见复发。结论：单孔后腹腔镜治疗肾囊肿具有创伤小、美容效果好及恢复快等优点,但手术操作要求高,需选择合适的病例及熟练掌握常规腹腔镜手术操作。

Objective：To compare the therapeutic outcomes and feasibility of laparoendoscopic single-site（LESS） Unroofing of renal cysts and standard laparoscopy. Methods：One hundred and twenty two patients with renal cysts were equally assigned to single-port group and traditional laparoscopic group. The clinical efficiency was compared between the two groups. Results：One hundred and twenty two patients are complete laparoscopic surgery and without serious complications. When the therapeutic outcomes of the two groups were compared, the average blood loss, average time lying in bed, analogue scale of pain and the length of the scar of the two groups were better than the conventional group（t=5.597, t=12.365, t=4.236, t=7.371;P〈0.05）. But the average operation time of the LESS group was longer than standard laparoscopy group. No recurrence was found in these two groups at 3-6 month Postoperative. Conclusion：Unroofing of renal cysts under laparoendoscopic single-site（LESS） has advantages of less trauma, better cosmetic effect, and quicker recovery. The learning curve of this procedure appears no steep for an experienced laparoscopist following a strict specialized training course.