声学造影在肾囊肿硬化治疗中的应用

目的：回顾分析囊肿内声学造影在肾囊肿硬化治疗中的应用价值,提高肾囊肿硬化治疗的安全性。方法：对33例接受肾囊肿硬化治疗的患者,于术前先行肾囊肿腔内声学造影：确认为单纯性肾囊肿,遂行肾囊肿硬化治疗;疑为肾盂源性肾囊肿,则放弃硬化治疗。结果：33例患者中,确认为单纯性肾囊肿并接受硬化治疗31例,有效率为87.1%;疑似肾盂源性囊肿2例,转行外科手术治疗。结论：囊肿内声学造影对鉴别单纯性与肾盂源性肾囊肿有较高的应用价值,可提高肾囊肿硬化治疗的安全性。     

经腹膜后腹腔镜肾囊肿去顶术治疗单纯性肾囊肿

目的 :探讨经腹膜后腹腔镜肾囊肿去顶术治疗单纯性肾囊肿的手术方法及注意事项。方法 :回顾分析 1 1例经腹膜后腹腔镜肾囊肿去顶术治疗单纯性肾囊肿的临床资料。结果 :手术成功率 1 0 0 % ,无中转开放手术和输血病例 ,未发生严重并发症。结论 :经腹膜后腹腔镜肾囊肿去顶术治疗单纯性肾囊肿安全有效 ,患者创伤小 ,康复快     

腹腔镜超声在后腹腔镜治疗复杂性肾囊肿中的临床应用

肾囊肿是泌尿外科的常见疾病,腹腔镜肾囊肿去顶减压术已是临床治疗肾囊肿的常规方法,但对复杂性肾囊肿,如分隔性囊肿、钙化性囊肿、出血性囊肿、钙乳性囊肿、囊肿合并感染、肾盂旁囊肿以及诊断不明的肾囊肿的治疗却较为困难。     

后腹腔镜肾囊肿去顶减压术336例报告

肾囊肿的治疗,以往多采用开放性。肾囊肿去顶术以及B超或CT引导下肾囊肿穿刺硬化剂治疗,前者创伤大、恢复慢,后者复发率高、并发症多[1]。腹腔镜手术创伤小,恢复快,并发症较少,术后疼痛轻,术后住院时间短[2,3],且腹腔镜手术与开放手术两者具有相同的治疗效果[4]。腹腔镜肾囊肿去顶减压术是治疗肾囊肿的最佳选择[5,6]。我科2006年6月～2011年12月采用后腹腔镜肾囊肿去顶减压术治疗单纯性。肾囊肿336例,疗效满意,现报道如下。     

超声引导经皮穿刺硬化治疗肾囊肿63例分析

目的探讨超声引导下细针穿刺硬化治疗肾囊肿的疗效。方法在超声引导下采用无水乙醇行细针穿刺硬化治疗肾囊肿63例。结果术后3个月随访,有效率100%。结论在超声引导下对肾囊肿行细针穿刺硬化治疗简单易行、并发症少、疗效确切,是肾囊肿的最佳治疗方法之一。     

单纯性肾囊肿的个体化治疗方案探讨

目的根据肾囊肿的部位个体化选择治疗方案,以提高单纯性肾囊肿的外科治疗效果。方法回顾性分析398例单纯性肾囊肿患者的临床资料,分析患者全身情况、囊肿位置及囊肿大小等特点与成功治疗肾囊肿的相关性。结果接受经皮穿刺引流并反复注射无水乙醇或联合生物蛋白胶的患者225例,接受经腹腔镜肾囊肿去顶减压术联合生物蛋白胶治疗的患者158例,接受输尿管镜下内切开引流术者15例。其中有效率99.5%,治愈率94.0%,无其他脏器损伤、感染性休克、化学性肾盂肾炎等严重并发症。结论单纯性肾囊肿患者应根据肾囊肿部位、个体化选择治疗方法。     

单纯性肾囊肿分型及其意义的研究

目的 提出一种对单纯性肾囊肿的分型方法,并探讨该分型方法的临床意义.方法 根据囊肿的大小、位置及是否突出于肾表面,分为3型:Ⅰ型囊肿直径≤3 cm;Ⅱ型囊肿直径>3 cm且位于肾实质内,没有突出于肾表面;Ⅲ型囊肿直径大于3 cm且突出于肾表面.对搜集到的135例单纯性肾囊肿患者进行分型,对不同类型患者的临床资料进行分析.结果 Ⅰ型肾囊肿患者中44例未予特殊处理,6例行穿刺硬化治疗术后3例复发;Ⅱ型肾囊肿患者中30例行腹腔镜肾囊肿去顶减压术,1例复发;6例行肾囊肿穿刺硬化治疗并放置引流管持续引流,1例复发;Ⅲ型肾囊肿患者中43例行腹腔镜肾囊肿去顶减压术,6例行肾囊肿穿刺硬化治疗,均未见复发.结论 通过分型便于临床描述,可以为临床医生对单纯性肾囊肿的处理提供一个有效地术前评估标准.Ⅰ型肾囊肿建议定期观察,Ⅱ型大者肾囊肿腹腔镜肾囊肿去项减压术应作为首选治疗方案,小者可以考虑行肾囊肿穿刺硬化并置管引流,Ⅲ型肾囊肿可以选择应用腹腔镜肾囊肿去项减压术或肾囊肿穿刺硬化治疗.     

腰部小切口囊肿去顶术治疗肾囊肿

肾囊肿是一种常见病多发病 ,治疗方法有肾囊肿去顶术 ,经皮肾穿刺肾囊肿硬化术 ,腹腔镜肾囊肿去顶术 ,但都有一些不尽人意的地方。 1999年 1月～ 2 0 0 3年 7月我们采用腰部小切口肾囊肿去顶术治疗肾囊肿 2 3例 ,现报告如下。临床资料1.一般资料 :本组 2 3例 ,男 17例 ,女 6例     

B超引导经皮穿刺酒精硬化治疗单纯性肾囊肿120例

目的观察应用B超引导穿刺酒精硬化治疗单纯性肾囊肿的效果。方法对120例单纯性肾囊肿患者予以B超引导穿刺酒精硬化治疗。结果所有病例均一次穿刺成功。术后6个月治愈率约93.3%。结论应用B超引导穿刺酒精硬化治疗单纯性肾囊肿具有创伤小、安全、疗效好、材料易得等优点,是单纯性肾囊肿理想的治疗方法。     

腹腔镜肾囊肿去顶引流术及疗效观察

目的：探讨腹腔镜肾囊肿去顶引流术的治疗效果。方法：在气管，静脉复合麻醉上通过腹腔镜行肾囊肿去顶引流术治疗肾囊肿１０例。结果：术后随访１－３年，９例获得成功１，例复发，无中，远期并发症。结论：此方法具有创伤小，恢复快等优点，是一种治疗肾囊肿的较好方法，对于较大肾囊肿，选用此法治疗应慎重。     

彩色多普勒超声引导介入治疗肾囊性病变387例

目的：总结彩色多普勒超声引导下介入治疗肾囊性病变的远期疗效。探讨彩色多普勒超声引导下介入穿刺治疗肾囊性病变的穿刺要点。方法：对387例良性肾囊性病变（其中单纯性肾囊肿291例、多囊肾96例）,其中男229例,女158例,年龄11岁～91岁,平均48.6岁。囊肿直径最大143mm×129mm,最小32mm×30mm。对387例良性肾囊性病变采用实时彩色多普勒超声引导穿刺硬化治疗,对直径〉80mm及囊内感染者治疗后保留导管持续引流。结果：单纯性肾囊肿中77例治疗后随访2年,214例随访6个月,266例囊肿完全消失、无复发;25例治疗后囊肿直径小于30mm,随访期内囊肿无明显增大。96例接受穿刺抽液硬化治疗多囊肾患者,治疗后随访6～24个月,肾功能得到不同程度改善或未继续恶化者70例,26例患者肾功能进行性下降。结论：实时超声引导可提高穿刺治疗肾囊肿的准确性,该法简便易行、创伤小、疗效可靠、并发症少,有较高的应用价值。     

Caliceal diverticula developing into simple renal cyst

Although common in adults simple cortical renal cysts are rare in children. Caliceal diverticula are rare in adults and children. A case of a caliceal diverticulum apparently sealing off and becoming an isolated simple cyst in the renal parenchyma has been reported as an unusual complication of caliceal diverticula. There have been 2 other cases of caliceal diverticula becoming sealed off reported in the literature, although neither progressed to frank cysts. We report 2 cases of definite caliceal diverticula progressing to simple renal cortical cysts.     

经输尿管镜下囊肿内切开引流术治疗肾囊肿

目的 探讨经输尿管镜下囊肿内切开引流术治疗肾囊肿的手术疗效和安全性.方法 肾囊肿患者30例.其中肾盂旁囊肿11例,单发囊肿15例,多发囊肿4例.既往肾囊肿手术史者3例.囊肿直径平均6.9(4.0～11.2)cm.影像学检查均可见囊肿对集合系统压迫形成的压迹.使用输尿管镜经尿道顺行至肾盂径路,观察肾囊肿对集合系统的压迫情况,直视下用电刀在囊肿压迫肾盂明显处位置做内切开.使其与集合系统贯通,并置双J管内引流.结果 30例手术均一次成功.囊肿处理时间平均31(15～45)min.手术时间平均61(30～120)min,住院时间平均6.5(4～7)d.无严重并发症发生.术后12 d实验室检查患者蛋白尿消失.平均随访6(3～9)个月,其中囊肿消失24例,明显缩小4例,复发2例.结论 经尿道输尿管镜技术处理肾囊肿具有安全、微创、近期疗效确切等优点.     

后腹腔镜下肾囊肿分型治疗的疗效观察

目的探讨后腹腔镜对单纯肾囊肿进行分型、治疗及其疗效观察。方法回顾性分析71例后腹腔镜手术治疗单纯肾囊肿患者的临床资料，初期23例未作分型直接行囊肿去顶，后期48例对囊肿分型后进行个性化治疗。结果初期23例未作分型处理的患者于术后3个月复查，7例（30．4％）有不同程度的残腔存留和复发；后期48例对囊肿分型（Ⅰ型18例、Ⅱ型21例、Ⅲ型9例）并作相应手术处理的患者术后3个月复查，2例有少量残腔存留（4．16％）。结论后腹腔镜手术治疗肾囊肿疗效确切，对肾囊肿分型并在术中进行个性化处理可提高疗效、降低术后复发率。     

Conservative and radiological management of simple renal cysts: a comprehensive review

What's known on the subject? and What does the study add? Simple renal cysts are a common entity, which may need observation and follow‐up or treatment. The study, for the first time, systematically reviews the indications for follow‐up or radiological treatment of simple renal cysts. To review the conservative and radiological management of simple renal cysts a systematic literature review was performed. Simple renal cysts are commonly found in the adult population. Increasing age is highly associated with its incidence. When they remain asymptomatic they require neither treatment nor follow‐up. When the shape of the cyst is slightly irregular follow‐up is mandatory to exclude malignant progression. Symptomatic cysts require intervention. Ultrasound or computed tomography guidance have been effectively used for cyst puncture. However, simple fluid aspiration is ineffective leading to cyst recurrence. Aspiration should be accompanied with the injection of a sclerosing agent to destroy renal cyst epithelium. Several issues such as the ultimate technique and agent remain to be clarified. High rates of cyst disappearance and long‐lasting cyst volume reduction have been reported with the use of various sclerosants. Ethanol in high concentrations and multiple injections is more commonly used with new agents showing similar efficacy and better complication profile. Studies comparing radiological intervention to surgical excision are lacking. Simple renal cysts may not require treatment when asymptomatic. Radiological intervention with the use of sclerosants needs further evaluation and comparison with other treatment methods.     

腹腔镜技术治疗复发性肾囊肿的探讨

目的：观察应用腹腔镜技术再次治疗腹腔镜肾囊肿去顶术后复发性囊肿的可行性。方法：总结5例腹腔镜技术治疗腹腔镜。肾囊肿去顶术后囊肿复发的临床资料,其中3例经腹腔途径,2例经腹膜后途径。结果：5例患者手术均获得成功。手术时间50～100min,平均75min。出血60～180ml,无并发症发生,术后住院4～9天,术后随访6～14个月,未再复发。结论：对于复发性肾囊肿仍可采取腹腔镜技术进行手术处理。     

腹腔镜下肝肾囊肿开窗去顶术的临床应用

目的:探讨腹腔镜治疗肝肾囊肿的方法和效果。方法: 1994至2004年于腹腔镜下为68例肝肾囊肿患者行开窗去顶术,其中肝囊肿56例,肾囊肿12例,并注入无水酒精灌洗残留粘膜。结果: 68例手术全部成功,无中转开腹。手术时间30~70min,随访时间6个月~10年, 1例复发。结论:腹腔镜治疗肝肾囊肿安全可行,在严格掌握适应证的条件下值得推广应用。     

Laparoscopic management of congenital seminal vesicle cysts associated with ipsilateral renal agenesis

PURPOSE: Congenital cysts of the seminal vesicles associated with ipsilateral renal abnormalities are rare. When they are symptomatic, open surgical excision has been the treatment of choice. We present our experience with laparoscopic management and provide a detailed literature review of this entity. MATERIALS AND METHODS: Since 1985, 3 patients with symptomatic seminal vesicle cysts and ipsilateral renal agenesis have been treated at our center. Open surgical excision was performed in 1 patient and laparoscopic management was performed in the other 2. RESULTS: Mean patient age was 35.7 years (range 30 to 42). Presenting symptoms were perineal pain in all 3 cases, dysuria in 2, irritable voiding in 2 and testicular pain in 1. Mean laparoscopic operative time was 195 minutes and mean estimated blood loss was 325 cc. Transabdominal or transrectal ultrasound was performed in 2 cases and computerized tomography was performed in all 3. CONCLUSIONS: Seminal vesicle cysts associated with ipsilateral renal agenesis are rare but they should be considered in men with otherwise inexplicable irritable voiding symptoms, perineal discomfort or other genitourinary complaint of unclear etiology. Evaluation should include digital rectal examination, transrectal and transabdominal ultrasound, computerized tomography and cystoscopy. Laparoscopy provides excellent intraoperative access and visualization with minimal postoperative morbidity. It is likely to become the treatment of choice for this rare developmental anomaly.     

A case of congenital unilateral multicystic kidney with renal matrix calculi

A forty-two-year-old man was seen with right lumbar pain. Physical examination revealed a right flank mass. Conventional excretory urography showed lack of right renal function, whereas left kidney was visualized. Right nephrectomy was performed. A cluster of several different sized cysts was disclosed in the right renal region. The renal surface was smooth. The removed kidney weighed 1,150 g. The ureter was completely obstructed at the ureteropelvic junction. Cysts were filled with matrix calculi. Pathological examination showed dysplastic glomeruli and primitive tubules within loose embryonic mesenchyme between two cysts whose walls consisted of smooth muscle strands and connective tissue. The final diagnosis was a congenital unilateral multicystic kidney with renal matrix calculi. The multicystic kidney is the most common form of renal cystic disease in infancy. However, few cases in adults have been reported. The diagnostic approach, treatment and outcome of a congenital unilateral multicystic kidney are discussed.     

腹膜后腹腔镜肾囊肿去顶术65例报告

目的:探讨腹膜后腹腔镜肾囊肿去顶术的方法.方法:回顾分析经腹膜后途径行腹腔镜肾囊肿去顶术65例的临床资料.结果:64例手术获得成功,1例因肾实质损伤中转开放手术.结论:腹膜后腹腔镜肾囊肿去顶术具有患者创伤小、出血少、康复快等优点,宜作为肾囊肿外科治疗的首选术式.