后腹腔镜肾囊肿去顶术治疗肾囊肿145例经验总结

目的:探讨后腹腔镜肾囊肿去顶术的安全性、有效性。方法:回顾性总结分析采用后腹腔镜肾囊肿去顶术治疗肾囊肿的临床资料,并复习文献。145例病例中73例女性,72例男性,年龄13~81岁,平均52岁。其中56例有腹痛、腹胀、肿块表现,36例有镜下血尿,18例存在上述两种表现,2例存在肉眼血尿,囊肿直径3~15 cm,73例为单发,72例为多发,44例位于肾上极,51例位于肾下极,14例位于肾中部,14例位于肾中上极,22例位于肾中下极。结果:144例肾囊肿顺利行后腹腔镜肾囊肿去顶术,75例行左侧去顶术,68例为右侧去顶术,1例行双侧手术,仅1例因术中肾周围组织粘连严重改为开放手术。手术时间15~255 m in,平均63 m in。术中出血量5~60 m l,平均35 m。l住院天数3~17 d,平均10.5 d。术后住院2~12 d,平均6.5 d。16例术后应用曲马多或盐酸哌替啶止痛。145例病理报告均为符合肾囊肿壁良性病变。全部病例随访半年~5年,1例术后6个月超声复查见囊肿复发。结论:后腹腔镜肾囊肿去顶术是安全、有效的方法,临床上已取代开放性肾囊肿去顶术成为肾囊肿外科手术治疗的金标准术式。

Retroperitoneal laparoscopic unroofing in the treatment of 145 cases with renal cyst

Objective To explore the safety and effectiveness of retroperitoneal laparoscopic unroofing in the treatment of renal cyst.Method The clinical materials of retroperitoneal laparoscopic unroofing were analysed retrospectively in 145 cases of renal cyst,and the literatures were reviewed.For 73 and 72 cases are women and men respectively,aged from 13 to 81 years,mean 52 years.For 56 patients had abdominal pain and bloating mass,36 patients with microscopic hematuria,18 cases have the two manifestations,there is gross hematuria in 2 cases,cyst diameter from 3 cm to 15 cm,73 patients had single and 72 had multiple cysts,44 patients in the renal upper pole,lower pole in 51 cases,14 cases in the renal center,14 cases were located in the upper-middle pole,22 cases in the lower-middle pole.Results With renal cysts removed,the operations were successfully accomplished in the 144 patients,75 cases with left side,68 cases with right side,1 case underwent bilateral operation,open roofing was done in only 1 case duing to the renal surrounding tissue severe adhesion.Operation time was from 15 to 255 min,average 63 min.Blood loss was from 5 to 60 ml,average 35 ml.Hospital stay was 3 to 17 days,average 10.5 days.Postoperative hospital stay was from 2 to 12 days,average 6.5 days.The tramadol or pethidine was used postoperatively only in 16 cases.Pathologic report of 145 cases were benign lesions consisting of renal cyst wall.All patients were followed from six months to five years,one case was found with cyst recurrence in 6 months after operation by ultrasound follow.Conclusion Retroperitoneal laparoscopic unroofing is a safe and effective procedure,this technique has displaced open unroofing operation and become the golden standary operation for the treatment of renal cyst.