后腹腔镜肾囊肿穿刺硬化联合去顶术治疗单纯性肾囊肿的疗效分析

Clinical observation on retroperitoneal laparoscopic unroofing combined with renal cyst puncture and ethanol sclerotherapy in treatment of simple renal cyst

目的探讨后腹腔镜肾囊肿穿刺硬化联合去顶术治疗单纯性肾囊肿的临床疗效,以减少术后复发,指导临床。方法回顾性分析2014年9月-2016年10月临沂市中心医院经影像学检查确诊且具备手术指征的单纯性肾囊肿患者116例。其中,56例行后腹腔镜去顶减压术(腔镜组);60例行后腹腔镜肾穿刺硬化联合去顶减压术(联合组)。比较两组患者手术时间、术中出血量、术中并发症发生率、术后第1天引流量、住院天数、住院费用、临床疗效及复发率。结果 116例手术全部成功,无中转开放手术。两组患者手术并发症发生率、出血量、住院天数、住院费用比较,差异无统计学意义(P>0.05),两组患者手术时间比较,差异有统计学意义(P<0.05),联合组手术时间长于腔镜组。两组术后第1天引流量、术后12、24个月临床疗效及术后复发率比较,差异有统计学意义(P<0.05)。结论后腹腔镜下肾囊肿穿刺硬化联合去顶术安全、有效,可减少术后囊肿复发率,值得临床推广。

Objective To evaluate the clinical efficacy of the retroperitoneal laparoscopic unroofing combined with renal cyst puncture and ethanol sclerotherapy in the treatment of simple renal cyst so as to reduce the recurrence of renal cyst and guide the clinical treatment. Methods We retrospectively analyzed 116 cases of simple renal cysts from January 2014 to October 2016, 56 treated by retroperitoneal laparoscopic deroofing( laparoscopic guoup, G), and the other 60 by retroperitoneal laparoscopic unroofing combined with renal cyst puncture and ethanol sclerotherapy(combination group, G). 116 cases were followed up from 26 to 51 months. The operation time, intraoperative hemorrhage, mount of drainage at 1 st day after operation, hospital stay, hospitalization expenses, intraoperative complication and recurrence rate were recorded and compared between the two groups. Results All the cases had a successful laparoscopic operation and no case had the conversion to open operation. There was no statistically significant differences in the incidence of complications, intraoperative hemorrhage, hospital stay, hospitalization expenses between the two groups(P>0.05). However, the operation time in LG was longer than CG(P<0.05).There were statistically significant differences in the amount of drainage at 1 st day after operation, the curative rate and recurrence rate 12 and 24 months after operation between the two groups(P<0.05). Conclusion Compared with the traditional method, the retroperitoneal laparoscopic unroofing combined with renal cyst puncture and ethanol sclerotherapy obtains satisfied effects, and the recurrence rate is very low.