摘要
目的比较经皮肾囊肿穿刺硬化治疗、小切口肾囊肿去顶术、经腹腔镜肾囊肿去顶术3种手术方法的优缺点，探讨肾囊肿手术方法的选择。方法回顾分析2001年1月～2004年11月3种方法治疗106例肾囊肿的临床资料，比较3种方法的手术时间、出血量、治疗费用、治愈率等。结果穿刺组治疗费用（3261．8±779．2）元最少，治愈率（78．6％，22／28）最低，复发率（21．4％，6／28）最高；小切口组手术时间（44．1±5．7）min最短；腹腔镜组治疗费用（9050．9±1116．2）元最高；以上指标3组间差异有显著性（P〈0．05）。小切口组和腹腔镜组治愈率均为100％，无复发病例，出血量和治愈率等指标差异无显著性（P〉0．05）。结论3种方法各有独特优势，应根据具体情况选择最佳手术方法。直径〈7cm的单纯性薄壁肾囊肿，若患者一般情况或经济条件较差可选择穿刺硬化治疗；肾下极或肾中部背侧单纯性薄壁囊肿可首选小切口肾囊肿去顶术；其他肾囊肿特别是双肾多发囊肿、巨大囊肿及不能排除恶性者应首选腹腔镜肾囊肿去顶术。
Objective To evaluate advantages and disadvantages of three procedures-percutaneous ethanol injection, small incision unroofing, and laparoscopic unroofing-in the treatment of renal cysts. Methods Clinical data of 106 cases of renal cysts from January 2001 to November 2004, treated either by percutaneous ethanol injection （ Percutaneous Group） , or small incision unroofing （Small Incision Group） , or laparoscopic unroofing （Laparoscopic Group） , were reviewed. The operation time, intraoperative blood loss, hospitalization costs, and cure rate were compared among the three procedures. Results The Percutaneous Group presented the least hospitalization costs （3 261.8 ± 779.2 yuan） , the lowest cure rate （78.6% ,22/28） , and the highest recurrence rate （21.4% ,6/28）. The Small Incision Group had the shortest operation time （44.1 ± 5.7 min） , and the Laparoscopic Group had the highest hospitalization costs （9 050.9 ± 1 116.2 yuan）. There were significant differences in these parameters among the three groups （P 〈 0.05 ）. Both Small Incision Group and Laparoscopic Group showed a cure rate of 100% without recurrence. There were no significant differences in blood loss and cure rate between these two groups （P 〉 0.05）. Conclusions The three procedures, with each having its own advantages, should be selected depending on individual conditions. For patients with a simple renal cyst 〈 7 cm in diameter and poor physical states or economic conditions, percutaneous ethanol injection is recommended; small incision unroofing can be employed for a simple renal cyst located at the lower pole or the middorsal part of the kidney ; laparoscopic unroofing is suitable for other types of renal cysts, especially bilateral multiple renal cysts, giant cysts, and cysts indistinguishable from renal cancer.
出处
《中国微创外科杂志》
CSCD
2006年第8期611-612,615,共3页
Chinese Journal of Minimally Invasive Surgery
关键词
肾囊肿
经皮肾囊肿穿刺
小切口
腹腔镜
Renal cyst
Percutaneous ethanol injection
Small incision
Laparoscopy
