腹腔镜肾囊肿去顶减压联合输尿管软镜铥激光内去顶治疗多囊肾的临床有效性及安全性  

Clinical Efficacy and Safety of Laparoscopic Renal Cyst Decapsulation Combined with Ureteroscopic Thulium Laser Cyst Decapsulation for the Treatment of Polycystic Kidney Disease

作　　者：顾腾飞 陈挺[1] 潘永涛 李杰[1] Gu Tengfei;Chen Ting;Pan Yongtao;Li Jie(Department of Urology,Lishui Central Hospital(The Fifth Hospital Affiliated to Wenzhou Medical University),Lishui 323000,China)

机构地区：[1]丽水市中心医院(温州医科大学附属第五医院)泌尿外科,丽水323000

出　　处：《微创泌尿外科杂志》2024年第6期365-371,共7页Journal of Minimally Invasive Urology

摘　　要：目的:探讨腹腔镜肾囊肿去顶减压联合输尿管软镜铥激光内去顶治疗多囊肾的有效性及安全性。方法:回顾性分析2021年10月至2023年12月在丽水市中心医院泌尿外科接受多囊肾手术治疗的患者40例,其中15例行腹腔镜肾囊肿去顶减压联合输尿管软镜铥激光内去顶手术(观察组),25例单纯行腹腔镜下肾囊肿去顶减压术(对照组)。比较两组患者的一般资料、手术特征、肾功能变化、局部症状以及生活质量。结果:两组患者术后病理均为良性肾囊肿,部分患者合并炎症改变。两组患者术后3个月术侧肾脏体积较术前均明显减少(P<0.05),且观察组较对照组减少更显著(P<0.05);观察组患者术后3个月、6个月血肌酐、术侧肾脏肾小球滤过率、血压均较对照组改善更明显(P<0.001)。与对照组相比,术后观察组患者术侧腰痛症状缓解明显、生活质量更优、术侧肾脏大囊肿处理更佳(均P<0.05)。观察组患者手术时间长于对照组(P<0.05)。两组术中出血、术后感染指标、术后住院时间以及术后患者发热比例比较差异均无统计学意义(P>0.05)。结论:腹腔镜内去顶减压联合输尿管软镜铥激光内去顶治疗多囊肾患者相比单纯腹腔镜内去顶手术,囊肿处理更彻底,肾功能改善和血压下降更明显,局部症状和生活质量改善也具有优势,且不增加手术风险及围术期并发症,值得临床推广。Objective:To investigate the efficacy and safety of laparoscopic renal cyst decapsulation combined with ureteroscopic thulium laser cyst decapsulation for the treatment of polycystic kidney disease(PKD).Methods:A retrospective analysis was performed on 40 patients who underwent surgical treatment for polycystic kidney disease at the Department of Urology,Lishui Central Hospital,between October 2021 and December 2023.Of these,15 pa⁃tients received laparoscopic renal cyst decapsulation combined with ureteroscopic thulium laser cyst decapsulation(ob⁃servation group),while 25 patients underwent only laparoscopic renal cyst decapsulation(control group).The gener⁃al data,surgical characteristics,renal function changes,local symptoms,and quality of life were compared between the two groups.Results:Pathology results for both groups indicated benign renal cysts,with some patients showing inflammatory changes.Three months postoperatively,the kidney volume on the surgical side had significantly re⁃duced in both groups compared to preoperative levels(P<0.05),with the reduction being more significant in the ob⁃servation group than in the control group(P<0.05).At 3 and 6 months postoperatively,the observation group showed greater improvement in serum creatinine,glomerular filtration rate(GFR)of the affected kidney,and blood pressure compared to the control group(P<0.001).The observation group also had significantly greater relief of flank pain,improved quality of life,and better management of large cysts on the affected kidney compared to the con⁃trol group(P<0.05).The observation group had a longer operative time than the control group(P<0.05).There were no significant differences between the two groups regarding intraoperative blood loss,postoperative infection rates,postoperative hospital stay,or incidence of postoperative fever(P>0.05).Conclusion:Laparoscopic renal cyst decapsulation combined with ureteroscopic thulium laser cyst decapsulation offers more thorough cyst treatment,greater improvement in renal fun

关 键 词：多囊肾 腹腔镜肾囊肿去顶 输尿管软镜内去顶 铥激光 

分 类 号：R699.2[医药卫生—泌尿科学]