Hoenig D M, McDougall E M, Shalhav A L, Elbahnasy A M, Clayman R V
Department of Radiology, Washington University, St. Louis, Missouri, USA.
J Urol. 1997 Oct;158(4):1345-8.
We describe and define the operative techniques, findings and results of laparoscopic ablation of peripelvic renal cysts.
One male and three female patients, ranging in age from 35 to 59 years, underwent laparoscopic ablation of symptomatic peripelvic cysts. All patients had symptoms of ipsilateral flank pain and obstruction. One patient had an episode of pyelonephritis before detection of the cyst, and 2 patients had concomitant stones within the obstructed system. Cysts ranged in size from 4 to 6 cm. Dissection was uniformly complex because of the depth to which the cyst extended into the renal parenchyma and the overlying renal vessels and collecting system.
Operative times ranged from 315 to 390 minutes (mean 338 minutes). The average length of hospital stay was 2.75 days (range 2 to 4 days). Three of 4 patients (75%) had resolution of their symptoms and collecting system obstruction. One patient, the only case of a retroperitoneal approach, had recurrence of her symptoms and cyst 2 months after the operation and required open surgical repair.
Laparoscopic ablation of peripelvic cysts is a challenging yet feasible procedure. Because of the medial location of these cysts, a transperitoneal approach may be preferable to retroperitoneal access alone.
我们描述并定义腹腔镜下肾周囊肿消融的手术技术、发现及结果。
1例男性和3例女性患者，年龄在35至59岁之间，接受了有症状肾周囊肿的腹腔镜消融术。所有患者均有同侧胁腹疼痛和梗阻症状。1例患者在囊肿发现前有肾盂肾炎发作，2例患者在梗阻系统内伴有结石。囊肿大小为4至6厘米。由于囊肿深入肾实质以及覆盖其上的肾血管和集合系统，解剖过程均较为复杂。
手术时间为315至390分钟（平均338分钟）。平均住院时间为2.75天（范围为2至4天）。4例患者中有3例（75%）症状及集合系统梗阻得到缓解。1例患者是唯一采用腹膜后入路的病例，术后2个月症状及囊肿复发，需要开放手术修复。
腹腔镜下肾周囊肿消融是一项具有挑战性但可行的手术。由于这些囊肿位于内侧，经腹腔入路可能比单纯腹膜后入路更可取。
