摘要
目的 探讨腹膜后腹腔镜肾囊肿手术的方法及疗效。 方法 35例采用全麻 ,水囊扩张后腹膜腔 ,通过腰大肌、腹膜返折、膈肌脚等标志找到并暴露肾囊肿 ,超声刀距肾实质 3～ 5mm将囊壁切除去顶。 结果 35例肾囊肿顺利切除去顶 ,手术时间 15～ 6 0min ,平均 32min。术中出血量 5～ 6 0ml,平均 35ml。术后住院 3～ 6d。 34例病理报告为良性病变 ,1例怀疑囊性腺癌。 35例随访 1～ 2 2个月 ,1例术后 1个月B超复查仍有直径 1 5cm囊肿 ,余未见囊肿复发。可疑腺癌者随访 1年 ,胸片及肝肾B超无肿瘤生长及转移灶。 结论 腹膜后腹腔镜肾囊肿去顶术是治疗肾囊肿安全、有效的方法。
Objective To explore the techniques and efficacy of retroperitoneal laparoscopic operations in the treatment of renal cyst. Methods A total of 35 patients were operated on under general anesthesia. A water-filled balloon was used to dilate the retroperitoneal cavity. The renal cyst was exposed by identifying the psoas major muscle, peritoneal reflection, pillar of diaphragm and so on. All cyst walls were unroofed with ultrasonic scalpel 3～5 mm from the edge of renal parenchyma. Results With renal cysts removed, the operations were successfully accomplished in all the 35 patients. The operation time was 15～60 min (mean, 32 min). The intraoperative blood loss was 5～60 ml (mean, 35 ml). The postoperative hospital stay was 3～6 days. Pathological examinations reported benign lesions in 34 patients and suspected cystadenocarcinoma in 1 patient. All the 35 patients were followed for 1～22 months. No recurrence was found with exception of 1 case of remaining renal cyst 1.5 cm in diameter under B-ultrasonography at the first postoperative month. The patient with suspected adenocarcinoma had been followed for 1 year and no evidences of neoplasm or metastasis were detected on the chest roentgenogram and B-ultrasonography of the liver and the kidneys. Conclusions Retroperitoneal laparoscopic unroofing is a safe and effective procedure for renal cyst.
出处
《中国微创外科杂志》
CSCD
2005年第1期67-68,共2页
Chinese Journal of Minimally Invasive Surgery
关键词
腹膜后
腹腔镜
肾囊肿
去顶术
Retroperitoneal
Laparoscopy
Renal cyst
Unroofing
