Department of Urology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, 321000, China.
BMC Surg. 2022 Aug 13;22(1):315. doi: 10.1186/s12893-022-01763-0.
This study aims to investigate the efficacy and safety of intraoperative real time ultrasound-assisted flexible ureteroscopic holmium laser incision and internal drainage in the treatment of parapelvic cysts, and to review recently published relevant literature.
This is a retrospective study in which the clinical data of 47 patients who underwent flexible ureteroscopic holmium laser incision and internal drainage of parapelvic cysts in our center from March 2017 to March 2021 were retrospectively analyzed. A literature search was conducted to review and summarize relevant reports on endoscopic treatment of parapelvic cysts published in the past 10 years.
Among 47 patients with parapelvic cysts who underwent flexible ureteroscopic holmium laser incision and internal drainage, 12 (25.53%) cases had a typical cyst wall bulging into the collecting system under flexible ureteroscope. As the cyst wall was thin and translucent in these cases, ultrasound was not used during the operation. The cysts of the remaining 35 patients were located with the aid of intraoperative real time ultrasound, and all underwent successful operation. No serious surgical complications occurred after surgery. The patients were followed up for 12-24 months after operation. The cyst in one case was observed larger than its original size before operation, so recurrence was considered. In another two cases, the diameters of the cysts were more than half of their original diameters before operation. Thus, the efficacy was poor in the three cases. For the remaining 44 cases, there was no obvious cyst observed or the diameter of the cysts was less than half their preoperative level.
The approach of ultrasound-assisted flexible ureteroscopic holmium laser incision and internal drainage in the treatment of parapelvic cysts is safe and effective, which helps to solve the problem of localization of atypical parapelvic cysts on endoscopic findings.
本研究旨在探讨术中实时超声辅助软性输尿管镜钬激光切开内引流术治疗肾盂旁囊肿的疗效和安全性，并复习近期相关文献。
这是一项回顾性研究，分析了 2017 年 3 月至 2021 年 3 月在我院接受软性输尿管镜钬激光切开内引流术治疗肾盂旁囊肿的 47 例患者的临床资料。检索了近 10 年来发表的关于内镜治疗肾盂旁囊肿的相关文献，并进行了回顾和总结。
47 例接受软性输尿管镜钬激光切开内引流术治疗的肾盂旁囊肿患者中，12 例（25.53%）在软性输尿管镜下可见典型的囊肿壁向集合系统膨出。由于这些病例的囊肿壁较薄且透明，术中未使用超声。其余 35 例患者的囊肿在术中实时超声的辅助下定位，并均成功进行了手术。术后无严重手术并发症发生。术后对患者进行了 12-24 个月的随访。1 例患者术后观察到囊肿较术前增大，考虑复发。另 2 例患者囊肿直径较术前缩小一半以上，疗效较差。在这 3 例中，疗效较差。其余 44 例患者囊肿无明显增大或囊肿直径较术前缩小一半以下。
超声辅助软性输尿管镜钬激光切开内引流术治疗肾盂旁囊肿安全有效，有助于解决内镜下发现不典型肾盂旁囊肿的定位问题。
