摘要
目的:研究在肾盂旁囊肿的治疗中超声联合输尿管软镜的潜在优势和局限性。方法:对2018年1月至2023年1月重庆医科大学附属永川医院泌尿外科收治的75例肾盂旁囊肿患者的临床资料进行回顾性分析。依据患者的手术方式为超声联合输尿管软镜内切开肾盂旁囊肿或腹腔镜下肾囊肿去顶减压术,患者分为软镜治疗组(40例)和腹腔镜组(35例)。通过比较两组之间的手术时间、失血量、术后囊肿复发率等指标,分别以t检验和卡方检验进行分析,以评估其应用效果和安全性。结果:软镜治疗组39例患者手术均成功完成,1例患者转为腹腔镜下肾囊肿去顶减压术;腹腔镜组35例患者手术均成功完成。与腹腔镜组比较,软镜治疗组失血量较少,术后疼痛发生率较低,术后住院天数及手术时间较短(P均<0.05);但手术费用(P<0.001)和术后血尿发生率较高(P=0.045)。两组术后发热比较差异无统计学意义(P>0.05),术后经过6~12个月的随访,两组患者囊肿均缩小消失,未观察到复发。结论:对于肾盂旁囊肿患者,输尿管软镜组相对于腹腔镜组具有术后恢复快、痛苦少的优点。然而,考虑到肾盂旁囊肿的结构复杂性以及输尿管软镜固有的角度限制,在选择这一手术方式之前需要仔细评估。
Objective:To investigate the potential advan tages and limitations of ultrasound-guided flexible ure-teroscopy in the management of parapelvic renal cysts.Methods:A retrospective analysis was conducted on 75 pa-tients with parapelvic cysts treated at the Department of Urology,Yongchuan Hospital of Chongqing Medical Univer-sity,between January 2018 and January 2023.Based on surgical approach,patients were divided into two groups:the flexible ureteroscopy group(n=40,undergoing ultrasonography-guided ureteroscopic internal incision)and the laparoscopic group(n=35,treated with laparoscopic cyst decortication).Perioperative outcomes(operative time,blood loss,postoperative cyst recurrence)were compared using independent t-test and chi-square test.Results:39 ureteroscopic procedures were successfully completed,with 1 case conversed to laparoscopy,as were all 35 laparo-scopic surgeries were successfully completed.Compared to laparoscopy,the ureteroscopy group demonstrated signifi-cantly reduced blood loss(P<0.05),lower postoperative pain incidence(P<0.05),shorter hospitalization(P<0.05),and decreased operative time(P<0.05).However,ureteroscopy was associated with higher surgical costs(P<0.001)and increased hematuria rates(P=0.045).No intergroup difference in postoperative fever was observed(P>0.05).During 6-12 months'follow-up,all cysts regressed without recurrence in both groups.Conclusion:For par-apelvic cysts,flexible ureteroscopy offers faster recovery and less morbidity than laparoscopy.However,due to ana-tomical complexity and the technique's inherent angular limitations,careful patient selection is warranted.
作者
李昌龙
张家模
赵德建
陈江川
Li Changlong;Zhang Jiamo;Zhao Dejian;Chen Jiangchuan(Department of Urology,the Affiliated Yongchuan Hospital of Chongqing Medical University,Chongqing 402160,China)
出处
《微创泌尿外科杂志》
2025年第2期97-101,共5页
Journal of Minimally Invasive Urology
基金
重庆市永川区公益类科研项目(2024yc-cxfz30029)
重庆医科大学附属永川医院院级课题(YJJL2024049)。
关键词
输尿管软镜
铥激光
肾盂旁囊肿
术后恢复
ureteroscopes
thulium
kidney diseases,cystic
postoperative period
