后腹腔镜治疗肾脏囊性疾病(附31例报告)

Retroperitioneoscopic operation of renal cystic disease(report of 31 cases)

目的 探讨后腹腔镜治疗肾脏囊性疾病的可行性。方法 对 2 8例 32侧 4 6个单纯性肾囊肿、2例肾盂旁囊肿及 1例双侧多囊肾经腰部腹膜后入路行腹腔镜肾囊肿去顶术。结果 30例手术成功 ,1例术中探查为肾皮质脓肿转为开放性手术。平均手术时间 5 2min ,平均住院 4 4d。术后 1例复发。结论 后腹腔镜肾囊肿去顶术治疗单纯性肾囊肿简单易行 ,安全、有效、损伤小、美观。术后住院时间短 ,康复快。可治疗肾盂旁囊肿 ,但对手术技术要求高。可对性质不明的囊肿进行探查。对多囊肾的疗效需进一步观察。

Objective To assess the clinical reliability of retroperitoneoscopic operation of renal cystic disease. Methods Thirty one patients were operated retroperitoneoscopically. Twenty eight patients with simple renal cysts, 2 with peripelvic cysts and one with polycystic kidney disease underwent retroperitoneoscopic unroofing of the cysts. Results Thirty cases were successful and one was converted to lumbotomy. In all cases the cyst wall was widely resected with no significant surgical complication. The mean operating time was 52 min and the mean hospital stay was 4 4 days. One patient developed a recurrence. Conclusion Retroperitoneoscopic unroofing is a feasible, safe, effective, cosmetic and minimally invasive treatment for simple renal cysts. This treatment shortens the hospitalization and recovery time after operation. Retroperitoneoscopic unroofing of peripelvic cysts is a challenging yet feasible procedure. Retroperitoneoscopic evaluation of indeterminate renal cysts seems to be sound. Further assessment on the effect on the outcome of polycystic kidney disease is necessary. Adequate exposure is essential for the effective treatment.