摘要
目的观察经皮输尿管镜下等离子柱状电极肾囊肿去顶术治疗单纯性肾囊肿的可行性和有效性。方法回顾性分析2016年10月~2017年7月我科收治的37例经影像学确诊为单纯性肾囊肿患者的临床资料。其中应用经皮等离子柱状电极肾囊肿去顶手术组16例,腹腔镜肾囊肿去顶手术组21例,记录两组手术时间、术中出血量、术后导尿时间、术后引流管留置时间、术后住院时间等指标,并比较两组指标有无差异。结果 37例患者手术均成功,术中及术后生命体征平稳,无中转开放手术,无血气胸、腹腔脏器损伤出血、感染相关并发症,无休克病例。等离子柱状电极手术组和腹腔镜手术组平均手术时间分别为34.5min,58.4min,两组比较,差异有显著性(P<0.05);术中失血量平均值分别为2.1ml,9.7ml(P<0.05);术后留置引流管时间平均值分别为2.9d,3.0d(P>0.05);尿管保留时间平均值分别为2.3d,1.9d(P>0.05);术后住院时间平均值分别为3.6d,4.0d(P>0.05)。经皮等离子柱状电极手术组1例患者术中出现集合系统破裂,予以留置D-J管保守治疗治愈。所有患者均治愈出院,随访至术后3~6个月经影像学检查原肾囊肿未再复发。结论经皮输尿管镜下等离子柱状电极肾囊肿去顶术与腹腔镜下肾囊肿去顶术比较,能缩短手术时间、减少术中出血量,治疗单纯性肾囊肿安全简便、可行有效。
Objective To assess the safety and efficacy of plasma column electrode renal cystectomy under percutaneous ureteroscopy in the treatment of simple renal cyst. Methods Between March 2016 and March 2017,37 patients with simple renal cysts were randomly divided into two groups,the Plasma column electrode group( 16 patients),and laparoscope group( 21 patients). The operative time,blood loss,days of drainage,catheter,and hospital stay and complications were compared between the two groups. All patients were followed up to 6 months after treatment. Results No patients had intraoperative complications such as hemopneumothorax,adjacent organ injury,infection or hemorrhage shock. In the plasma column electrode group and laparoscope group: the mean operation time was 34. 5 min vs 58. 4 min( P 〈0. 05). The mean blood loss was 2. 1 ml vs 9. 7 ml( P 〈0. 05). The mean postoperative indwelling drainage tube time was 2. 9 d vs 3. 0 d( P 〉0. 05). The mean catheter retention time was 2. 3 d vs 1. 9 d( P 〉0. 05). The mean postoperative hospital stay was 3. 6 d vs 4. 0 d( P 〉0. 05). One patient in electrode group was suffered from rupture of the collecting system during the operation,and was treated by indwelling D-J stent. During follow up,no cysts recurrence was found. Conclusion Percutaneous ureteroscopic plasma column electrode decortication is a safe,minimally invasive and effective therapy to treat simple renal cysts,with equal efficacy and advantages in shortening the operation time and reducing the amount of intraoperative bleeding compared with laparoscopic decortication.
作者
张程榕
孙国宝
孙源胜
姚久杰
刘伟光
ZHANG Chengrong;SUN Guobao;SUN Yuansheng;YAO Jiujie;LIU Weiguang(Department of Surgery,Weifang Medical University,Weifang 261053,China;Department of Urology,the Affiliated Hospital of Weifang Medical University)
出处
《潍坊医学院学报》
2018年第4期241-244,共4页
Acta Academiae Medicinae Weifang
关键词
经皮输尿管镜
等离子柱状电极
腹腔镜去顶
肾囊肿
Percutaneous ureteroscopy
Plasma column electrode
Laparoscopic decortication
Renal cyst