输尿管软镜下钬激光切开内引流术治疗肾盂旁囊肿的临床研究  

Clinical research of endo-decortication of peripelvic cyst by flexible ureterscope with Holium laser

作　　者：俞蔚文[1] 张大宏[1] 何翔[1] 徐智慧[1] 王旭亮[2] 廖国栋[2] 邓刚[2] 水冰[2] 

机构地区：[1]杭州,浙江省人民医院泌尿外科,310014 [2]杭州市第一人民医院泌尿外科

出　　处：《中华泌尿外科杂志》2013年第7期489-492,共4页Chinese Journal of Urology

摘　　要：目的 探讨经尿道输尿管软镜下钬激光切开内引流术治疗肾盂旁囊肿的安全性和可行性. 方法 回顾性分析2010年1月至2012年10月收治的11例肾盂旁囊肿患者的临床资料,男6例,女5例.年龄36～67岁,平均54岁.单发肾盂旁囊肿4例,双侧肾盂旁囊肿2例,一侧肾盂旁囊肿伴对侧单纯肾囊肿1例,肾盂旁囊肿伴同侧肾结石4例.囊肿直径平均4.8cm.全麻下行经尿道输尿管软镜下钬激光切开内引流术,逆行经尿道置入8.5～9.9 F电子输尿管软镜,观察集合系统与囊肿的解剖位置.直视下用200μm钬激光光纤将向集合系统凸起的囊壁开窗引流,开窗直径1～2cm,使囊腔与集合系相通,留置双J管引流. 结果 11例手术均成功.每侧囊肿处理时间13～27min,平均20min.术中、术后无严重并发症发生.术后随访3～24个月,8例囊肿消失,3例囊肿明显缩小,未见囊肿复发. 结论经尿道输尿管软镜下钬激光切开内引流术治疗肾盂旁囊肿具有创伤小、恢复快、近期疗效确切等优点,理论上更符合经自然腔道手术的优点,远期疗效有待进一步观察随访.Objective To evaluate the efficacy and safety of peripelvic cyst endo-decortication by flexible ureterscope with Holium laser. Methods A retrospective review of 11 cases of peripelvic cyst was done from January, 2011 to October, 2012.The 11 patients were including 4 cases of single peripelvic cyst and 7 cases of complex or multiple peripelvic cyst （mean 4.8 cm in diameter）, male 6 and female 5, average age 54 years old. All patients had undergone endo-decortication by flexible ure- terscope. With general anesthesia, Olympus electronic flexible ureterscope （Fr 8.5/9.9） accessed pel- vis retrogradely and decorticated peripelvic cyst with 200 ~m Holium laser to drainage the cyst to pel- vis. Double J stent was placed at the end of procedure. Results All operations were successful with- out severe complications. The mean operating time was 20 min. （13--27 min.）. In 3--24 month fol- low-up, 8 patients＂ peripelvic cyst undetectable in ultrasound or CT scan, diminished in 3 patients and no relapse. Conclusions The endo-decortication of peripelvic cyst by flexible ureterscope with Holi- um laser could be effective, minimal invasive and safe.

关 键 词：输尿管软镜 肾盂旁囊肿 治疗 

分 类 号：R699.2[医药卫生—泌尿科学]