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手指辅助腹腔镜肾囊肿切除术:一种简单的技术。

Finger assisted laparoscopic renal cyst excision: a simple technique.

作者信息

Kilciler Mete, Istanbulluoğlu Mustafa Okan, Basal Seref, Bedir Selahattin, Avci Ali, Ozgök Yaşar

机构信息

Gulhane Faculty of Medicine, Department of Urology, Ankara, Turkey.

出版信息

Urol J. 2010 Jun 10;7(2):90-4; discussion 94.

Abstract

PURPOSE

Simple renal cysts are asymptomatic incidental findings; however, for a small subset of benign renal cysts, patients may present with pain, hematuria, recurrent infection, pyelocaliceal obstruction, or hypertension. Laparoscopic cyst ablation is an effective minimally invasive modality for the treatment of symptomatic benign renal cysts. We describe a simple laparoscopic cyst excision technique.

MATERIALS AND METHODS

Between June 2003 and May 2008, 28 patients underwent laparoscopic renal cyst excision via retroperitoneal approach. In our technique, retroperitoneum and Gerota's fascia were dissected with finger blindly before insertion of the trocars to the retroperitoneal space. Following finger dissection, 3 trocars were placed and the cyst walls were excised at the level of renal cyst and base of the cysts were cauterized with electrocautery scissors.

RESULTS

Mean patients' age was 59.3 years (range, 31 to 72 years). Mean operation duration time was 46 minutes (range, 27 to 102 minutes). Symptomatic and radiological success were achieved in 26 (92.8%) and 27 (96.4%) patients, respectively, with a median follow-up of 28 months (range, 6 to 56 months). No serious complications were encountered.

CONCLUSION

Laparoscopy is a versatile minimally invasive modality ideal for treating benign symptomatic renal cysts. According to our experience, we think that the finger assisted laparoscopic cyst excision is an easy and noninvasive procedure.

摘要

目的

单纯性肾囊肿通常为无症状的偶然发现;然而,一小部分良性肾囊肿患者可能会出现疼痛、血尿、反复感染、肾盂肾盏梗阻或高血压。腹腔镜囊肿切除术是治疗有症状的良性肾囊肿的一种有效的微创方法。我们描述一种简单的腹腔镜囊肿切除技术。

材料与方法

2003年6月至2008年5月,28例患者经腹膜后途径行腹腔镜肾囊肿切除术。在我们的技术中,在将套管针插入腹膜后间隙之前,先用手指盲目分离腹膜后间隙和肾周筋膜。手指分离后,放置3个套管针,在肾囊肿水平切除囊肿壁,并用高频电刀剪刀烧灼囊肿底部。

结果

患者平均年龄为59.3岁(范围31至72岁)。平均手术持续时间为46分钟(范围27至102分钟)。26例(92.8%)患者症状缓解且影像学检查成功,27例(96.4%)患者影像学检查成功,中位随访时间为28个月(范围6至56个月)。未出现严重并发症。

结论

腹腔镜检查是治疗有症状的良性肾囊肿的一种通用的微创方法。根据我们的经验,我们认为手指辅助腹腔镜囊肿切除术是一种简单且无创的手术。

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