腹腔镜下治疗成人脐尿管囊肿的临床分析

Laparoscopic management of urachal cyst in adulthood

目的 探讨腹腔镜下脐尿管囊肿切除术治疗脐尿管囊肿的临床疗效.方法 回顾性分析2011年10月至2015年10月本院5例脐尿管囊肿患者进行腹腔镜下脐尿管囊肿切除术的临床资料及手术结果.结果 5例患者中4例手术获得了成功,其中1例术前具有腹膜炎体征的患者中转为开放手术,术中均无大出血、周围及腹腔脏器损伤等严重并发症;手术时间平均108 min（60～ 150 min）,失血量平均约37 mL（20～65 mL）,术后住院天数平均8d,2周后均恢复日常活动.4例患者术后病检证实脐尿管囊肿,1例病检回报示脐尿管肉芽肿性炎症,倾向于结核,术后给予抗结核治疗半年;所有患者随访6个月到1年,术后无肉眼血尿、切口感染及囊肿复发、恶变等.结论 腹腔镜下脐尿管囊肿切除术安全有效,可以作为治疗脐尿管囊肿的首选手术方式.对于不伴有脐尿管膀胱瘘者,可不必同时行膀胱袖口切除术.

Objectives To investigate the efficacy of laparoscopic excision of urachal cyst.Methods Five patients with urachal cyst underwent laparoscopic excision from October 2011 to October 2015.The data and operation results were retrospectively analysed.Results All five operations had no serious immediate complications and minimal blood loss.One case with signs of peritonitis was converted to open operation.The average operation time was 108 min （60 ～ 150 min）,the average blood loss was 37 mL（20 ～65 mL）,the postoperative hospital stay and the mean recovery time of daily activities was 8 days and 2 weeks respectively.Four cases were confirmed urachal cyst by pathological examination,one case of biopsy showed granulomatous inflammation was considered to be tuberculosis.The case was healed after continuing anti-tuberculosis therapy for 6 months.All patients were followed up for 6 months to 1 year without gross hematuria,postoperative infection and recurrence and malignant change.Conclusions Laparoscopic excision of urachal cyst is safe and effective,which can be used as the preferred surgical treatment of urachal cyst.For the patient without vesico-urachal fistula,the excision of bladder cuff is not necessary.