Chen Hualin, Chen Gang, Pan Yang, Jin Xiaoxiang
Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
Urol J. 2021 Jan 26;18(4):389-394. doi: 10.22037/uj.v16i7.6466.
To compare the efficiency and safety of two minimally invasive surgeries, laparoscopy and flexible ureteroscopy (fURS), in the management of renal parapelvic cysts.
Between January 2013 and April 2019, patients who suffered from parapelvic cysts and received fURS or laparoscopy at our hospital were recruited for this study. All patients underwent biopsies of the cyst wall. Primary outcome was treatment success, which was defined as symptomatic and radiological. During follow-up, telephone contact and CT scans were used to record any relevant symptoms and any recurrence, respectively.
A total of 33 patients (22 in fURS; 11 in laparoscopy) were included in this study. Flank pain prior to the procedures were reported by 14/22 patients and 6/11 in fURS and laparoscopy, respectively (P = .62), and patients had complete pain relief after the operation. The complication rate was significantly lower in the fURS group than in the laparoscopy group (P = .01). Minor complications were observed in 3/22 and 5/11 patients (Grade 1 and 2) in the fURS and laparoscopy group, respectively. All patients were controlled by conservative treatment. However, 1/11 major complication (Grade 3b) was detected in the laparoscopy group and managed by ureteroscopy to remove the obstruction under general anesthesia. Significant differences were found in operative time (P = .01) and postoperative hospital stay (P = .01), while medical expenses were similar between the two groups (P = .42). During follow-up, no recurrence was detected in CT scans.
In the management of parapelvic cysts, two minimally invasive surgeries were comparable in efficiency. However, fURS was superior to laparoscopic unroofing with regard to the complication rate, operative time, and postoperative hospital stay.
比较腹腔镜手术和软性输尿管镜检查（fURS）这两种微创手术治疗肾盂旁囊肿的有效性和安全性。
2013年1月至2019年4月期间，选取我院收治的患有肾盂旁囊肿并接受fURS或腹腔镜手术的患者纳入本研究。所有患者均接受了囊肿壁活检。主要结局指标为治疗成功，定义为症状缓解和影像学改善。随访期间，分别通过电话联系和CT扫描记录任何相关症状及复发情况。
本研究共纳入33例患者（fURS组22例；腹腔镜手术组11例）。fURS组和腹腔镜手术组术前分别有14/22例和6/11例患者出现胁腹痛（P = 0.62），术后患者疼痛均完全缓解。fURS组的并发症发生率显著低于腹腔镜手术组（P = 0.01）。fURS组和腹腔镜手术组分别有3/22例和5/11例患者出现轻微并发症（1级和2级），所有患者均通过保守治疗得到控制。然而，腹腔镜手术组发现1例严重并发症（3b级），并在全身麻醉下通过输尿管镜检查解除梗阻。两组手术时间（P = 0.01）和术后住院时间（P = 0.01）存在显著差异，而两组医疗费用相似（P = 0.42）。随访期间，CT扫描未发现复发。
在肾盂旁囊肿的治疗中，两种微创手术的有效性相当。然而，在并发症发生率、手术时间和术后住院时间方面，fURS优于腹腔镜囊肿去顶术。
