Topaktas Ramazan, Akkoc Ali, Altin Selcuk, Aydin Cemil, Urkmez Ahmet
Haydarpasa Numune Training and Research Hospital, Clinic of Urology, Istanbul.
Diyarbakir Gazi Yasargil Training and Research Hospital, Clinic of Urology, Diyarbakir, Turkey.
J Pak Med Assoc. 2018 Jul;68(7):1124-1128.
We retrospectively evaluated the results of Harmonic Scalpel (Ethicon, Cincinnati, Ohio) used for laparoscopic decortication of simple renal cysts (SRC). Between May 2011 and December 2014, 28 patients with symptomatic SRC (Bosniak type 1) underwent laparoscopic decortication with Harmonic Scalpel, were reviewed. All cysts were evaluated with ultrasonography and abdominal computed tomography. Symptomatic and surgical success was defined as no recurrence on computed tomography imaging and complete pain relief, respectively. The mean age of patients was 51.7±9.6 years and there were 16 female and 12 male. While a transperitoneal approach was preferred in 18 cases, a retroperitoneal approach was chosen in 10 patients. The mean cyst size and duration of operation was 8,8±2,8 (6-12) cm and 72,8±28,4 (50-110) minutes, respectively. A total of three minor complications were observed postoperatively. Mean hospital stay was 1,3±0,9 (1-3) days. After the mean 12,6±3,2 (3-24) months follow-up the radiological and symptomatic successes were 100% and 89,2%, respectively. Our results showed that laparoscopic decortication of SRC using Harmonic Scalpel is consistent with the literature and provides a reasonable complication but increases cost.
我们回顾性评估了超声刀（爱惜康公司，俄亥俄州辛辛那提市）用于腹腔镜下单纯性肾囊肿（SRC）去顶减压术的效果。在2011年5月至2014年12月期间，对28例有症状的SRC（博斯尼亚克1型）患者行超声刀腹腔镜下囊肿去顶减压术并进行回顾性分析。所有囊肿均行超声及腹部计算机断层扫描评估。有症状缓解及手术成功分别定义为计算机断层扫描成像无复发及疼痛完全缓解。患者平均年龄为51.7±9.6岁，其中女性16例，男性12例。18例患者首选经腹腔途径，10例患者选择经腹膜后途径。囊肿平均大小及手术时间分别为8.8±2.8（6 - 12）cm和72.8±28.4（50 - 110）分钟。术后共观察到3例轻微并发症。平均住院时间为1.3±0.9（1 - 3）天。平均随访12.6±3.2（3 - 24）个月后，影像学及症状缓解成功率分别为100%和89.2%。我们的结果表明，超声刀腹腔镜下SRC去顶减压术与文献报道一致，并发症合理，但成本增加。
