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使用LigaSure进行腹腔镜下肾门囊肿去顶减压术。

Laparoscopic decortication of hilar renal cysts using LigaSure.

作者信息

Erdem Mehmet Remzi, Tepeler Abdulkadir, Gunes Mustafa, Sılay Mesrur Selcuk, Akman Tolga, Akcay Muzaffer, Armagan Abdullah, Onol Sinasi Yavuz

机构信息

Urology Department, Haydarpasa Research and Training Hospital, Tibbiye Street, Selimiye, Uskudar, Istanbul, Turkey.

Urology Department, Bezmialem Vakif University, Istanbul, Turkey.

出版信息

JSLS. 2014 Apr-Jun;18(2):301-7. doi: 10.4293/108680813X13753907291558.

Abstract

BACKGROUND AND OBJECTIVES

In this study, we evaluated the safety and efficacy of using the LigaSure sealing system (Valleylab, Boulder, Colorado) for laparoscopic decortication of symptomatic hilar renal cysts.

METHODS

Seventeen patients underwent laparoscopic decortication of hilar renal cysts with the LigaSure system. Our study included only symptomatic, Bosniak type 1, simple and symptomatic renal cysts. The operative route, transperitoneal or retroperitoneal, was planned according to the location confirmed by computed tomography. The patients' symptoms were preoperatively and postoperatively evaluated by the Wong-Baker visual pain scale. Operative measures and radiologic outcomes were prospectively evaluated.

RESULTS

The mean age of the patients was 56.4 years, and the mean follow-up period was 12.5 months. Preoperative computed tomography showed only a single cyst in 15 patients (88.2%) and showed two separate cysts in 2 cases (11.8%). The cysts were located in the perihilar region close to the vascular structure in all patients. A transperitoneal approach was used in 9 patients, and a retroperitoneal approach was used in 8 patients. The mean operative time and hospitalization time were 56.4 minutes and 1.2 days, respectively. Minor complications were observed in 3 patients. Symptomatic and radiologic success rates of 94.2% and 100%, respectively, were achieved.

CONCLUSION

Laparoscopic decortication of symptomatic hilar renal cysts--first reported in the literature in this study--using the LigaSure sealing system is feasible, effective, and safe, even if the cyst is located in the perihilar area.

摘要

背景与目的

在本研究中,我们评估了使用LigaSure封闭系统(美国科罗拉多州博尔德市柯惠医疗公司)对有症状的肾门部肾囊肿进行腹腔镜去皮质术的安全性和有效性。

方法

17例患者使用LigaSure系统接受了腹腔镜下肾门部肾囊肿去皮质术。我们的研究仅纳入有症状的Bosniak 1型单纯性有症状肾囊肿。根据计算机断层扫描确定的位置规划手术路径,经腹腔或腹膜后途径。术前和术后通过Wong-Baker视觉疼痛量表评估患者症状。前瞻性评估手术措施和影像学结果。

结果

患者的平均年龄为56.4岁,平均随访期为12.5个月。术前计算机断层扫描显示,15例患者(88.2%)仅有单个囊肿,2例患者(11.8%)有两个独立囊肿。所有患者的囊肿均位于靠近血管结构的肾门周围区域。9例患者采用经腹腔途径,8例患者采用腹膜后途径。平均手术时间和住院时间分别为56.4分钟和1.2天。3例患者出现轻微并发症。症状缓解率和影像学成功率分别达到94.2%和100%。

结论

本研究首次在文献中报道,使用LigaSure封闭系统对有症状的肾门部肾囊肿进行腹腔镜去皮质术是可行、有效且安全的,即使囊肿位于肾门区域。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/713e/4035644/1236634e0b6d/jls0041331650001.jpg

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