输尿管软镜与腹腔镜治疗肾盂旁囊肿对比分析

Flexible Ureteroscopy versus Laparoscopy in Treatment of Parapelvic Cyst

目的:对比分析经尿道输尿管软镜钬激光肾盂旁囊肿内切开引流术与腹腔镜下肾盂旁囊肿去顶减压术的临床疗效。方法:选取我院2005年1月至2015年1月收治肾盂旁囊肿48例患者作为研究对象,其中的23例行经尿道输尿管软镜钬激光肾盂旁囊肿内切开引流术,另25例行腹腔镜下肾盂旁囊肿去顶减压术。收集2组患者手术时间、术中出血量、通气时间、下床时间、术后住院日、术后感染及出血、随访1年复发情况等数据,并行统计学分析。结果:经尿道输尿管软镜钬激光肾盂旁囊肿内切开引流术较腹腔镜下肾盂旁囊肿去顶减压术手术时间及术中出血量显著减少(P<0.05),而通气时间、下床时间及术后住院日无显著性差异(P>0.05)。随访1年肾盂旁囊肿均未复发。结论:对于治疗肾盂旁囊肿的微创手术方法,输尿管软镜手术和腹腔镜手术均安全有效,输尿管软镜在人体自然的腔道内操作,具无创口、出血少、恢复快、并发症较少等优点,缺点是出院带双J管可致尿路刺激征、腰痛等症状。

Objective： To compare transurethral flexible ureteroscopy plus holmium laser incision and drainage （ TFU＋HLID） with laparoscopic parapelvic cyst decortication （ LPCD） in treatment of parapelvic cyst .Methods：48 patients were enrolled from January 2005 to January 2015.Of them, 23 cases underwent TFU ＋HLID） and the other 25 cases did LPCD.The operation time, intraoperative blood loss , ventilation time, bed time, postoperative hospital day , postoperative infection and bleeding and recurrence after one-year were recorded and statistically analyzed .Results：TFU＋HLID demonstrated shorter operation time and less intraoperative blood loss than LPCD （P〈0.05）.However, there were no significant differences in ventilation time ,bed time and postoperative hospital day between the two procedures （ P 〉0.05 ） .Conclusion： As for minimally invasive surgery for parapelvic cyst , both flexible ureteroscopy and laparoscopy are safe and effective .Flexible ureteroscopy is performed in natural body cavity and has advantages such as no wound , less bleeding , faster recovery , fewer complications , but its disadvantage is that bearing double J tube can induce urinary tract irritation , back pain and other symptoms .