肾囊肿穿刺硬化术联合后腹腔镜去顶术的疗效观察

Clinical observation on retroperitoneal laparoscopic unroofing combined with percutaneous ethanol injection in treatment of simple renal cyst

目的探讨肾囊肿穿刺硬化术联合后腹腔肾囊肿去顶减压术的疗效观察,以减少术后复发,指导临床治疗。方法选取2010年1月至2014年12月5年间本院收治的122例肾囊肿患者,根据治疗方式不同分为2组:观察组65例行穿刺硬化术联合后腹腔镜肾囊肿去顶术,对照组57例行后腹腔镜肾囊肿去顶术。记录并比较2组的手术时间,术中出血量,住院时间,术后并发症及复发率。结果 122例肾囊肿均成功实施后腹腔镜下手术治疗,无1例中转开放手术。观察组手术时间(55.1±3.6)min,术中出血量(30.2±5.2)m L,住院时间(6.1±1.6)d;对照组手术时间(32.5±2.6)min,术中出血量(28.5±4.8)m L,住院时间(5.9±1.3),除手术时间之外,余差异均无统计学意义(P>0.05),2组均无迟发性出血、尿漏和切口感染等并发症,但治疗组有3例术后出现肾绞痛,治疗组无一例术后复发,对照组5例复发,复发率为8.8%。结论穿刺硬化术联合后腹腔镜肾囊肿去顶术较单纯的后腹腔镜肾囊肿去顶术治疗效果满意,术后复发率低,值得临床推广。

Objective To evaluate the effect and application value of the retroperitoneal laparoscopic unroofing combined with percutaneous ethanol injection in the treatment of simple renal cyst so as to reduce the recurrence of renal cyst and guide the clinical treatment. Methods A total of 122 patients with renal cysts admitted to the the First People＇s Hospital of Xuzhou from January 2010 to December 2014 were divided into a treatment group （65 cases） and control group （57cases）. The treatment group was given retroperitoneal laparoscopic unroofing combined with pereutaneous ethanol injec- tion, while the control received the traditional laparoscopic operation. The operation time, intraoperative hemorrhage, hospi- tal stay, postoperative complication and recurrence rate were recorded and compared between the two groups. Results All the 122 cases had a successful laparoscopie operation and no case had the conversion to open operation. The operation time [（55.1±3.6） min vs （32.5±2.6） min], intraoperative hemorrhage [（30.2±5.2） ml vs （28.5±4.8） ml] and hospital stay [（6.1± 1.6） d vs （5.9±1.3）] between the treatment group and control group showed no statistically significant difference except the operation time （P〉0.05）. However, there were 3 cases of renal colic in the treatment group. No cyst recurred in the treat- ment group but 5 cases recurred in the control group with a recurrence rate of 8.8%. Conclusion Compared with the traditional method, the retroperitoneal laparoscopie unroofing combined with pereutaneous ethanol injection obtains satisfied effects, and the recurrence rate is very low.