腹腔镜囊肿去顶术治疗肾盂旁囊肿和肾外周囊肿效果比较  

Laparoscopic decortication of renal cysts:comparison of peripelvic and peripheral renal cysts

作　　者：邵世修[1] 张淑香[1] 尚东浩[2] 王晓[1] 董胜国[1] 

机构地区：[1]青岛大学医学院附属医院,山东青岛266003 [2]日本京都大学医学院附属医院

出　　处：《山东医药》2007年第8期10-12,共3页Shandong Medical Journal

摘　　要：目的对比肾盂旁和肾外周囊肿行腹腔镜去顶术的近远期疗效。方法110例行腹腔镜单纯肾囊肿去顶术患者,其中肾盂旁囊肿28例(PPRC组),肾外周囊肿82例(PRC组),对两组手术和随访资料进行对比分析。结果预期完成手术106例,两组术中转开放手术各2例。PPRC组与PRC组相比,手术时间长、失血量多,术后3个月、1 a的疼痛缓解率低,CT囊肿复发率高,P均<0.05。结论腹腔镜行肾周边囊肿去顶术微创、安全、有效;腹腔镜行肾盂旁囊肿去顶术难度大、复发率较高,应探索更好的方法提高肾盂旁囊肿的治疗效果。[objective] To assess the efficacy of laparoscopic decortication of peripelvic and peripheral renal cysts. [Methods] 110 consecutive eligibile patients with symptomatic renal cysts who underwent laparoscopic decortication of renal cysts （28 peripelvic, 82 peripheral）, the records of them were retrospectively reviewed. Comparative analysis included the patient＇s demographics, intraoperative parameters, postoperative and fol- lowup outcomes. Results 106 procedures were technically successful while two cases were electively converted to open surgery in each group respectively. When comparing patients with peripelvie and peripheral cysts,statistically significant differences were noted in the mean operative time （133 vs 78 minutes,P=0. 01）, estimated blood loss （211.5 vs 70 ml, P=0. 01）, postoperative pain relief rate （69.2% vs 85.0% in three months,P=0. 034; 57.7% vs 78.8% in twelve months,P=0. 022,respectively） and computerized tomographic success rate （23.1%0 vs 10. 0% in three months,P=0. 001; 30.8% vs 12.1% in twelve months,P=0.001, respectively）. [Conclusions] Laparoscopic decortication of cysts is a safe, minimally invasive and effective treatment for peripheral renal cysts, while it was relatively difficult for peripelvic renal cysts. The laparoscopic decortication of peripelvic renal cysts shows a relatively high postoperative recurrence rate and a low pain relief rate compared with the PRC. The intraoperative techniques in laparoscopic decortication of peripelvic renal cysts should be modified to increase the postoperative effectiveness in the future.

关 键 词：肾脏 囊肿 腹腔镜 

分 类 号：R692[医药卫生—泌尿科学]