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经皮输尿管镜等离子柱状电极去顶术与腹腔镜去顶术治疗单纯性肾囊肿的随机研究

Randomized study of percutaneous ureteroscopic plasma column electrode decortication and laparoscopic decortication in managing simple renal cyst.

作者信息

Liu Weiguang, Zhang Chengrong, Wang Bohan, Li Bao, Gao Guojun, Sun Guobao, Sun Yuansheng, Lin Guiting

机构信息

Department of Urology, The Affiliated Hospital, Weifang Medical University, Weifang 261031, China.

Department of Surgery, Weifang Medical Unveristy, Weifang 261053, China.

出版信息

Transl Androl Urol. 2018 Apr;7(2):260-265. doi: 10.21037/tau.2018.03.08.

Abstract

BACKGROUND

To assess the safety and efficacy of a novel technology referred to as percutaneous ureteroscopic plasma column electrode (PCE) by comparing laparoscopic decortication in the management of simple renal cyst (SRC).

METHODS

Between March 2016 and June 2017, 53 patients with SRCs were randomized to divided into two groups, the PCE group (24 patients), or laparoscope group (29 patients). The operative time, blood loss, days of drainage, catheter, and hospital stay and complications were compared with the two groups. All patients were followed- up to 6 months after treatment.

RESULTS

No patients had intraoperative complications such as hemopneumothorax, adjacent organ injury, infection or hemorrhage shock. In the PCE group and laparoscope group: the mean operation time was 34.1±8.2 58.4±16.7 min (P<0.05). The mean blood loss was 2.0±1.16 9.7±4.09 mL (P<0.05). The mean postoperative indwelling drainage tube time was 2.5±1.5 2.9±1.09 d (P>0.05). The mean intra-urethral indwelling catheter time was 2.1±0.88 2.0±1.15 d (P>0.05). The mean postoperative hospital stay was 3.0±1.7 3.7±1.53 (P>0.05). One patient in electrode group was suffered from rupture of the collecting system during the operation, and was treated by indwelling D-J stent. During follow up, no cysts recurrence was found.

CONCLUSIONS

Percutaneous ureteroscopic PCE decortication is a safe, minimally invasive and effective therapy to treat SRCs, with equal efficacy and advantages in shortening the operation time and reducing the amount of intraoperative bleeding compared with laparoscopic decortication.

摘要

背景

通过比较腹腔镜去顶术与经皮输尿管镜等离子柱状电极(PCE)技术治疗单纯性肾囊肿(SRC)的效果,评估该新技术的安全性和有效性。

方法

2016年3月至2017年6月,53例SRC患者被随机分为两组,PCE组(24例)和腹腔镜组(29例)。比较两组的手术时间、出血量、引流天数、置管情况、住院时间及并发症。所有患者治疗后随访6个月。

结果

所有患者术中均未出现血气胸、邻近器官损伤、感染或出血性休克等并发症。PCE组和腹腔镜组:平均手术时间分别为34.1±8.2分钟和58.4±16.7分钟(P<0.05)。平均出血量分别为2.0±1.16毫升和9.7±4.09毫升(P<0.05)。术后平均留置引流管时间分别为2.5±1.5天和2.9±1.09天(P>0.05)。平均尿道留置导尿管时间分别为2.1±0.88天和2.0±1.15天(P>0.05)。术后平均住院时间分别为3.0±1.7天和3.7±1.53天(P>0.05)。电极组1例患者术中出现集合系统破裂,通过留置D-J管治疗。随访期间,未发现囊肿复发。

结论

经皮输尿管镜PCE去顶术治疗SRC安全、微创且有效,与腹腔镜去顶术相比,疗效相当,在缩短手术时间和减少术中出血量方面具有优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53d6/5911539/393f6bf4a396/tau-07-02-260-f1.jpg

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