Wada T, Kamiryo Y, Tsuchida M, Kato M
Department of Urology, Saiseikai Shimonoseki General Hospital.
Hinyokika Kiyo. 1995 Nov;41(11):861-5.
Laparoscopic unroofing of a renal cyst was performed in 13 cases of simple cysts of 48 ml. to 678 ml. (mean: 217 ml.) preoperatively measured by ultrasonography from April, 1994 through April, 1995 at our Department of Urology. Under general anesthesia, the renal cyst wall was resected as close as possible to the renal parenchyma by the laparoscopic technique. The postoperative outcome was evaluated in 12 of 13 cases, except for the one case converted to laparotomy because of uncontrollable bleeding from the resected site of the renal parenchyma. Three months after the operation, complete disappearance of the renal cyst was noted by CT scanning in 10 of the 12 cases. In the remaining 2 cases, the renal cyst was still in existence despite the apparent reduction of the cyst volume. In one case in which a somewhat large cyst remained, sclerotherapy using minocycline was carried out. No serious complications during the operation were observed, but in one case with uncontrollable bleeding as mentioned above, the postoperative course was uneventful. These findings indicate that, the laparoscopic unroofing of a renal cyst is a safe and useful procedure for a relatively large renal simple cyst, therefore this approach seems to be acceptable, and before long it will be an ordinary urological operation.
1994年4月至1995年4月,我们泌尿外科对13例单纯性肾囊肿患者实施了腹腔镜下肾囊肿去顶术,术前经超声测量囊肿体积为48毫升至678毫升(平均217毫升)。在全身麻醉下,采用腹腔镜技术尽可能贴近肾实质切除肾囊肿壁。13例中有1例因肾实质切除部位出血无法控制而转为开腹手术,其余12例对术后结果进行了评估。术后3个月,12例中的10例经CT扫描显示肾囊肿完全消失。其余2例囊肿体积虽明显缩小,但仍然存在。其中1例残留稍大囊肿的患者,采用米诺环素进行了硬化治疗。手术过程中未观察到严重并发症,但上述1例出血无法控制的患者术后恢复顺利。这些结果表明,腹腔镜下肾囊肿去顶术对于相对较大的单纯性肾囊肿是一种安全有效的手术方法,因此这种手术方式似乎是可以接受的,并且不久后将会成为一种常规的泌尿外科手术。