腹腔镜治疗腹腔巨大囊肿及术后下身水肿处理(附5例报告)

目的探讨腹腔镜处理腹腔巨大囊肿及术后下身水肿的方法. 方法 5例腹腔巨大囊肿先行囊肿抽液(1 500～2 000 ml,平均1 800 ml)减压,2例巨大肝囊肿采用经皮穿刺抽液,3例下腹腔囊肿在脐缘小切口直视下抽液,使腹腔空间增大后行腹腔镜下囊肿切除(3例)或开窗引流(2例).对术后出现的下身水肿口服(2例)或静脉注射(3例)利尿剂. 结果 4例术后症状完全消失,1例多囊肝症状明显改善.随访3个月～1年,症状无复发.下身水肿均在5～7 d内基本消失. 结论先行囊肿抽液减压及术后应用小剂量利尿剂可使腹腔巨大囊肿能在腹腔镜下顺利处理并恢复.

Treatment of giant intraabdominal cysts and postoperative lower body edema: Report of 5 cases

Objective To investigate the laparoscopic treatment for giant intraabdominal cysts with postoperative lower body edema. Methods Five cases of giant intraabdominal cysts were given an aspiration of 1 500 ~ 2 000 ml (mean, 1 800 ml) of fluid. The aspiration was performed percutaneously in 2 cases of hepatic cyst, and under direct vision through a 1.5~2.5 cm incision around the umbilics in 3 cases of lower intraabdominal cyst. After aspiration the cysts were excised (3 cases) or fenestrated (2 cases) laparoscopically. Postoperative lower body edema was treated with diuretics either orally (2 cases) or intravenously (3 cases). Results Symptoms completely disappeared after operation in 4 cases and were significantly improved in 1 case of polycystic liver. Follow-up for 3~12 months found no recurrence. The lower body edema subsided in 5~7 days after operation. Conclusions Aspiration of cystic fluid before laparoscopic operation and postoperative administration of diuretics could get good results for patients with giant intraabdominal cysts.