直接闭合式经腹膜后腹腔镜肾囊肿去顶术治疗肾囊肿

目的 探讨直接闭合式经腹膜后腹腔镜肾囊肿去顶术治疗效果. 方法 1996年12月～2003年9月,我院采用直接闭合式方法经腹膜后腹腔镜肾囊肿去顶术治疗肾囊11例.腰部髂嵴上2 cm腋中线交界处做小切口1～2 cm,深度至皮下组织,10 mm trocar直接穿刺进入后腹腔,自制注水气囊扩张腹膜后间隙,充分暴露肾囊肿,距离肾实质边缘0.5～1.0 cm处电刀切除囊壁. 结果 10例手术获得成功,手术时间30～100 min,平均77.5 min.术中出血量20～60 ml,平均30.9 ml.1例因暴露囊肿困难中转开放性手术.1例腹膜损伤.术后住院6～9 d,平均7.4 d.7例随访7～26个月,平均15.2月,B超检查肾囊肿无复发. 结论 直接闭合式经腹膜后腹腔镜肾囊肿去顶术创伤小、恢复快、疗效可靠.

Closed retroperitoneoscopic decortication of 11 cases of renal cysts

Objective To evaluate the efficacy of closed retroperitoneoscopic decortication of renal cysts.Methods Closed retroperitoneoscopic decortication of renal cysts was performed in 11 cases from December 1996 to September 2003 in this hospital.A 1~2 cm skin incision 2 cm above the iliac crest was made in the middle axillary line.A 10 mm trocar was introduced into the retroperitoneal cavity.A self-made water-filled balloon was used to create a retroperitoneal space for clearing the renal cyst.An electrocautery scalpel was used to excise the cyst wall until 0.5~1.0 cm away from the renal parenchyma.Results The procedure was successfully completed in 10 cases,with an operation time of 30~100 min(mean,77.5 min) and an intraoperative hemorrhage volume of 20~60 ml(mean,30.9 ml).A conversion to open surgery was required in 1 case because of difficult exposure of the renal cyst.Peritoneal injury was encountered in 1 case.The length of postoperative hospital stay was 6~9 days(mean,7.4 days).(Follow-up) observations in 7 cases for 7~26 months(mean,15.2 months) showed no recurrence of renal cyst under ultrasonography.Conclusions Closed retroperitoneoscopic decortication of renal cysts is a surgical option with little invasion,quick recovery,and good efficacy.