后腹腔镜手术治疗65例肾囊肿.doc

后腹腔镜手术治疗65例肾囊肿[摘要] 目的：探讨后腹腔镜肾囊肿去顶术的方法及疗效。方法：65例采用全身麻醉，健侧卧位，经后腹腔途径建立后腹腔操作空间，在腹腔镜监视下，寻找肾囊肿，充分暴露囊肿边缘，肾囊肿中央戳孔，吸除囊液，提起囊壁距肾实质0.5 cm切除，常规留置引流管后结束手术，1～2 d拔除引流管。结果：65例手术均获成功；手术时间40～120 min，平均60 min；术中出血10～30 ml，平均20 ml；术后1、2 d下床活动；无术后大出血、漏尿等并发症发生；术后随访3～18个月，B超或CT复查未见囊肿复发。结论：后腹腔镜肾囊肿去顶术疗效明确，具有损伤小、术后恢复快、痛苦小和住院时间短等优点，是一种安全、有效的方法，可作为治疗肾囊肿的首选。 [关键词] 后腹膜；腹腔镜；肾囊肿；去顶术 [中图分类号]R699.2 [文献标识码]C [文章编号]1673-7210（2008）08（a）-179-02 Retroperitoneoscopic surgery for 65 patients with renal cyst YAN Bing,FU Jie-xin,LIU Yong-gang,LI Yu-ying,HUANG Hen-qing (Department of Urogy, The First Hospital of Nanning, Nanning 530022, China) [Abstract] Objective：To explore the techniques and efficacy of retroperitoneoscopic unroofing of renal cyst.Methods：A total of 65 patients were performed general anaesthesia，in position on uninjured side，established the operational space through retroperitoneal. Looking for the renal cyst under the monitoring of laparoscope, cysts edge were fully exposed, stabbed a hole in the center of the cyst and siphoned out the cyst fluid.All cysts were unroofed 0.5 cm far from renal parenchyma, ended the operation after putting the drainage-tube routinely,and it was pulled out after 1～2 postoperative days.Results：The operation were successfully accomplished in all patients. The operation time was 40～120 (60) min. The intraoperative bleeding was 10～30(20) ml, the patients got out of bed after 1～2 days postoperatively. No major haemorrhage, leakage of urine happened postoperatively. Follow up time was 3～18 months. No recurrence was found under B-supersonic or CT.Conclusion：Retropertoneal laparoscopic unroofing is a safe and effective procedure for renal cyst. [Key words] Posterior peritoneum;Laparoscopy;Renal cyst;Unroofing 肾囊肿是成人较常见的良性疾病，多在肾表面生长，直径达4 cm时往往引起症状[1]，主要临床表现是患侧腰胀痛等。过去主要采用穿刺抽吸注入硬化剂或开放肾囊肿去顶术治疗。我院2003年4月～2007年10月采用后腹腔镜肾囊肿去顶术治疗65例，效果满意。现报道如下： 1资料与方法 1.1一般资料 本组65例。男34例，女31例；年龄23～84岁，平均48.8岁。囊肿位于左肾29例，右肾36例。囊肿直径4.0～9.0 cm，平均6.3 cm。本组病例选择标准：患侧腰部