肾盂旁囊肿的后腹腔镜手术选择(附39例报告)  

Retroperitoneal laparoscopic parapelvic cyst unroofing for treatment of parapelvic cyst(Report of 39 cases)

作　　者：高健刚[1] 孙小庆[1] 侯四川[1] 朱磊一[1] 白鑫[1] 祝海[1] 刘之俊[1] 贾勇[1] 翁博文[1] 邱志磊[1] 

机构地区：[1]青岛市市立医院东院泌尿外科,山东青岛266071

出　　处：《临床泌尿外科杂志》2012年第11期807-808,813,共3页Journal of Clinical Urology

摘　　要：目的:探讨和分析肾盂旁囊肿(parapelvic cyst)的临床特征,腹腔镜手术选择的有效性和安全性。方法:39例肾盂旁囊肿的患者进行IVU、B超、螺旋CT、肾核素显像等检查,根据检查结果明确诊断,并对有手术指证的患者行腹腔镜手术治疗。以手术时间、术后胃肠功能恢复时间、术后半年复查CT及双肾GFR为观察指标。结果:39例患者手术治疗,囊肿最大直径2.5～6.5cm,平均(4.1±1.5)cm。均行腹腔镜肾盂旁囊肿去顶术,囊肿切除后残端用1～2枚塑料夹夹闭,防止囊肿残端闭合。手术时间45～123(68±15)min。术中出血30～110(55±17)ml,均未输血。术后胃肠功能恢复时间24～40(32±10)h。术后2～3d拔除切口引流管。住院4～7(5.7±2.3)d,术后病理均为良性囊壁组织。随诊12～36个月,平均17.5个月,其中术后半年复查CT及双肾GFR。患者症状均消失,无术后并发症,无复发,25.6%患者GFR较术前提高。结论:螺旋CT及三维重建有利于肾盂旁囊肿的鉴别诊断,可为进一步选择治疗方法提供指导。随着技术的不断进步,腹腔镜手术治疗安全、有效,已成为目前肾盂旁囊肿的最佳治疗方法。Objective：To assess the clinical characteristics of renal pelvis cyst,the efficacy and safety of laparo- scopic surgery choice. Method： Thirty nine cases of patients with renal pelvis cyst of the IVU. ultrasound, spiral CT, renal scintigraphy,according to confirm the diagnosis, and partial patients underwent retroperitoneal laparosco- py： Operative time, postoperative recovery time of gastrointestinal function. CT scan follow up after 6 months.and kidney GFR were used as barometers. Result：Thirty-nine cases were successfully accomplished, The cysts size were from 2.5 to 6.5 cm in diameter.and mean size was（4. 1±1.5） cm. Underwent laparoscopic unroofing of renal pel- vis cyst,cyst excision stump with 1 to 2 Hemolok clip to prevent the cyst stump closed. The mean operanve nine was （68±15） mintrange 45 to 123 min）.and the mean estimated blood loss was （55±17）ml（range 30 to 110 ml）. No patient received blood transfusion. The mean recovery time of gastrointestinal function was 32 h（range 24 to 40 h）. And after 2 to 3d drainage incision tubes were removed The mean hospital stay was（5.7±2.3） d（range 4 to 7 d）. The cysts were diagnosed as benign lesion from pathologic examination. In the follow-up of 12 to 36 months （mean 17.5 months） ,after 6 months follow-CT and kidneys GFR. all patients achieved symptomatic relief.no post- operative complications occurred and no recurrence. The GFR in 25.6% patients increased compared with preoper- ative. Conclusion：Spiral and Three-dimensional CT is conducive to the differential diagnosis of renal pelvis cyst. Laparoscopic surgery is a safe and efficacious procedure. With the continuous advancement of technology,it could be one of the best choices for parapelvic cyst.

关 键 词：肾盂旁囊肿 后腹腔镜 腹膜后 

分 类 号：R737.11[医药卫生—肿瘤]