单孔后腹腔镜与标准后腹腔镜肾蒂背外侧型肾盂旁囊肿去顶术的比较

Comparative study of single-site retroperitoneal laparoendoscopic and standard laparoscopic renal cyst unroofing in treatment of renal pedicle dorsal parapelvic cyst

目的探讨单孔后腹腔镜下肾蒂背外侧型肾盂旁囊肿去顶术的有效性、安全性及可行性。方法回顾梅州市人民医院泌尿外科2006年1月至2014年9月分别用单孔后腹腔镜和标准后腹腔镜囊肿去顶术治疗13例和15例肾蒂背外侧型肾盂旁囊肿的患者资料,对两种手术的手术时间、术中出血量、术后肠道恢复时间、术后引流量、术后拔除引流管时间、术后住院天数、手术并发症、术后疼痛、术后患者满意度、术后切口美容效果和术后囊肿复发率等指标进行比较分析。结果两组患者均顺利完成手术,无一例中转开放手术,术中和术后无一例患者出现大出血、腹腔脏器损伤等严重并发症,无一例死亡,随访12个月患者症状均明显改善或解除,无一例复发。单孔组患者的手术时间较标准组长,但术后患者满意度和切口美容效果明显优于标准组(P<0.05)。两组患者在术中出血量、术后肠道恢复时间、术后引流量、术后拔管时间、术后住院天数、围手术期手术并发症、术后疼痛和囊肿复发率等指标比较,差异无统计学意义(P>0.05)。结论单孔后腹腔镜去顶术治疗肾蒂背外侧型肾盂旁囊肿是一种安全、有效的手术方法,与标准腹腔镜技术比较,它具有更好的美容效果和患者满意度。

Objective To explore the efficacy, safety and feasibility of single-site retroperitoneal laparoendoscopic renal cyst unroofing in treatment of pedicle dorsal parapelvic cyst. Methods From June 2006 to September 2014, 13 and 15 patients with renal pedicle dorsal parapelvic cyst were performed single-site retroperitoneal laparoendoscopic （single-site group） and standard laparoscopic （standard group） renal cyst unroofing respectively in MeiZhou People＇s Hospital. The operation time, intraoperative blood loss, time of intestinal function recovery, postoperative drainage volume, drainage tube removal duration, postoperative hospital stay, postoperative pain score, the cosmetic results, patient satisfaction and one-year recurrence rate was compared between the two groups. ～ All the operations were completed successfully, without conversion to standard open surgery. No intraoperative and postoperative serious complications and death occurred. The cosmetic results of single-site group were better than the standard group, but the operation time was longer than the standard group. No significant difference was observed in other data between the two groups. Conclusions It is safe, effective and feasible for single-site retroperitoneal laparoendoscopic renal cyst unroofing to treat pedicle dorsal parapelvic cyst. It has the same clinical effect as standard laparoscopic surgery and has better cosmetic results and patient satisfaction.