后腹腔镜治疗肾盂旁囊肿
Retroperitoneoscopic deroofing of peripelvic renal cysts
目的 探讨后腹腔镜治疗肾盂旁囊肿的可行性、注意事项及临床治疗效果.方法 用腹腔镜从腹膜后路径治疗有症状的肾孟旁囊肿16例.其中男5例,女11例.年龄26~68岁,平均38.2岁.左肾盂囊肿6例,右肾盂囊肿10例.囊肿最大5.7 cm,最小2.4 cm.术后进行随访观察.结果 本组病例16例手术顺利,手术时间30~100 min,平均50 min;术中出血30~150 ml.无一例术中输血.术后第2天可下床活动,引流管平均引流量35 ml.平均住院5 d.无术后出血、感染、皮下气肿和不能拔管等并发症.病例随访3个月,所有病人症状消失,肾盂受压解除.结论 虽然后腹腔镜治疗肾盂旁囊肿技术较复杂,但其对治疗有症状的肾盂旁囊肿来说具有创伤小,出血少、恢复快、安全可靠、住院时间短、疗效确切等优点.同时应强调手术人员的泌尿外科手术基础、腹腔镜操作演练经验和严格把握适应证.
更多Objective To evaluate the safety and feasibility of performing retroperitoneoscopic cystectomy of peripelvic renal cysts.Methods Five men and eleven women (mean age 38.2) with a peripelvic renal cyst associated with ipsilateral flank pain were treated by retroperitoneoscopic deroofing using a three-port technique. Cyst size ranged from 2.4 to 5.7 cm. Patients were followed with radio-logic imaging and B-utrasonography at 3 and 6 months thereafter. Results In all cases, the laparoscopic procedure was suecossful.The operative time ranged from 30 to 100 minutes (mean 50 minutes), and the mean blood loss was < 100 ml. The mean postoperative hospital stay was 5 days (range 3-8 days). At a mean follow-up of 3 months, symptoms and collecting system obstruction had re-solved in all patients. Conclusion Although retroperitoneoscopic cystectomy of peripelvie renal cysts is technically challenging, it is a safe and efficacious procedure and offers a favorable minimally invasive alternative for the treatment of symptomatic cysts.
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