Tefekli Ahmet, Altunrende Fatih, Baykal Murat, Sarilar Omer, Kabay Sahin, Muslumanoglu Ahmet Yaser
Department of Urology, Haseki Teaching and Research Hospital, Istanbul, Turkey.
Int J Urol. 2006 Apr;13(4):331-6. doi: 10.1111/j.1442-2042.2006.01299.x.
To analyse the efficacy, safety and feasibility of retroperitoneal laparoscopic decortication of simple renal cysts using bipolar PlasmaKinetic scissors.
Records of 19 patients who underwent laparoscopic decortication of simple renal cysts, performed with bipolar PlasmaKinetic scissors without additional fulguration of the base or the margin of resection, were retrospectively reviewed. Long-term symptomatic and radiological outcomes were assessed.
One single cyst was treated in fourteen (73.7%) cases, two cysts in three (15.8%) cases, three cysts in one (5.2%) case and multiple cysts in one case with autosomal dominant polycystic kidney disease. They were peripherally located in thirteen, peripelvic in three, and parenchymal in two cases. An average of 3.1 trochars were used for each procedure. The mean operating time was 82.5 +/- 16.7 min (range, 50-135). Neither open conversion nor blood transfusion was necessary. A total of six minor complications were encountered. Mean hospital stay 2.3 +/- 0.9 days (range, 1-4). After a mean follow up of 14.3 +/- 5.9 months (range, 3-24), symptomatic success was achieved in 89.5%, and radiological success was accomplished in 88.2%. An asymptomatic cyst recurrence was observed in one (5.9%) case, and one (5.9%) case with residual pain had new cyst formation at another site of the kidney.
Retroperitoneal laparoscopic cyst decortication using bipolar PlasmaKinetic scissors is a feasible and efficient method, eliminating further fulguration of the base and the margins of the cysts. Operating times are shorter than previously published series and highly satisfactory long-term success rates are achieved.
分析使用双极等离子体动力剪刀行腹膜后腹腔镜单纯性肾囊肿去顶减压术的疗效、安全性及可行性。
回顾性分析19例行腹腔镜单纯性肾囊肿去顶减压术患者的病历资料，手术采用双极等离子体动力剪刀，未对囊肿基底部或切除边缘进行额外电凝。评估长期症状及影像学结果。
14例（73.7%）患者治疗单个囊肿，3例（15.8%）患者治疗2个囊肿，1例（5.2%）患者治疗3个囊肿，1例常染色体显性遗传性多囊肾病患者治疗多个囊肿。囊肿位于周边部13例，肾盂周围3例，实质内2例。每次手术平均使用3.1个穿刺套管。平均手术时间为82.5±16.7分钟（范围50 - 135分钟）。无需中转开放手术或输血。共发生6例轻微并发症。平均住院时间2.3±0.9天（范围1 - 4天）。平均随访14.3±5.9个月（范围3 - 24个月），症状缓解成功率为89.5%，影像学成功治愈率为88.2%。1例（5.9%）患者出现无症状囊肿复发，1例（5.9%）患者残留疼痛，在肾脏另一部位有新囊肿形成。
使用双极等离子体动力剪刀行腹膜后腹腔镜囊肿去顶减压术是一种可行且有效的方法，无需对囊肿基底部和边缘进行进一步电凝。手术时间短于既往报道系列，长期成功率高且令人满意。
