Chen Hequn, Li Yang, Zeng Feng, He Cheng, Cui Yu, Chen Jinbo, Zeng Huimin, Lu Siqi, Wang Weiguo, Chen Zhiyong
Department of Urology, Xiangya Hospital, Central South University, Changsha, China.
Transl Androl Urol. 2020 Dec;9(6):2764-2770. doi: 10.21037/tau-20-875.
To assess the safety, feasibility, and efficacy of a modified process we developed in order to perform decortication surgeries for simple renal cysts through a percutaneous approach, 18 patients with simple renal cysts larger than 5 cm were treated with our new technique, from November 2016 to January 2019. All of the cysts were evaluated with ultrasonography and contrast-enhanced computed tomography. The Surgical procedure: as the standard mini-Percutaneous Nephrostomy procedure, a puncture was made directly into the cyst through the cyst roof under ultrasound guidance. After the inner cyst wall examination, the sheath was then retracted to just outside the cyst roof. The sheath together with the scope was used to detach the roof from the perirenal fat, after which the cyst roof was resected using a laser. A drain tube was left in the retroperitoneal space for 1-2 days. Subsequently, all patients were discharged 1 to 2 days post-surgery. Skin incision was less than 1 cm. No major complication was observed. The follow-up time ranges from 14 to 37 months. One case had an incompletely resected cyst with the cyst volume being decreased by more than 60%. This patient didn't receive any additional treatments during his follow-up. For all the other patients, the cysts had completely disappeared and no relapse had occurred. In conclusion, in the selected patients with a simple posterior renal cyst, our new technique is a safe and an effective option. It is also considered the least invasive decortication surgery for posterior renal cyst.
为了评估我们开发的一种改良方法用于经皮途径对单纯性肾囊肿进行去顶手术的安全性、可行性和有效性，从2016年11月至2019年1月，我们采用新技术对18例囊肿直径大于5 cm的单纯性肾囊肿患者进行了治疗。所有囊肿均通过超声和增强CT进行评估。手术步骤：按照标准的微创经皮肾造瘘术，在超声引导下直接经囊肿顶部穿刺进入囊肿。检查囊肿内壁后，将鞘管退至囊肿顶部外侧。用鞘管和内镜将囊肿顶部与肾周脂肪分离，然后用激光切除囊肿顶部。在腹膜后间隙留置引流管1 - 2天。随后，所有患者术后1至2天出院。皮肤切口小于1 cm。未观察到严重并发症。随访时间为14至37个月。1例患者囊肿切除不完全，囊肿体积缩小超过60%。该患者在随访期间未接受任何额外治疗。对于所有其他患者，囊肿已完全消失且未复发。总之，对于所选的单纯性肾后囊肿患者，我们的新技术是一种安全有效的选择。它也被认为是肾后囊肿最微创的去顶手术。
