腹膜后腹腔镜肾囊肿去顶减压术34例报告

目的:探讨经腹膜后腹腔镜肾囊肿去顶减压术的临床应用价值。方法:回顾分析34例患者行腹膜后腹腔镜肾囊肿去顶减压术的临床资料。结果:所有患者手术均获成功;平均手术时间53min,失血19ml。随访3个月至9年,原手术部位无囊肿复发。结论:腹膜后腹腔镜肾囊肿去顶减压术是治疗单纯性肾囊肿和多囊肾的最好方法,患者创伤小、康复快、住院时间短,且可早期下床活动。     

腹腔镜手术治疗肾囊肿56例报告

目的:探讨腹腔镜治疗肾囊肿的手术方法及疗效。方法:回顾分析56例肾囊肿患者全麻经腹腔或腹膜后途径行腹腔镜肾囊肿去顶减压术的临床资料。结果:53例手术成功,经腹膜后途径3例中转开放手术。手术时间40~150min,平均60min,术中出血10~100ml,术后无严重并发症发生,住院时间5~7d。41例术后随访3~6个月,无囊肿复发。结论:腹腔镜肾囊肿去顶减压术具有患者创伤小、术后康复快、疼痛轻等优点,是治疗肾囊肿安全有效的方法。     

Retroperitoneal laparoscopic decortication of simple renal cysts using the bipolar PlasmaKinetic scissors

OBJECTIVES: To analyse the efficacy, safety and feasibility of retroperitoneal laparoscopic decortication of simple renal cysts using bipolar PlasmaKinetic scissors. METHODS: Records of 19 patients who underwent laparoscopic decortication of simple renal cysts, performed with bipolar PlasmaKinetic scissors without additional fulguration of the base or the margin of resection, were retrospectively reviewed. Long-term symptomatic and radiological outcomes were assessed. RESULTS: One single cyst was treated in fourteen (73.7%) cases, two cysts in three (15.8%) cases, three cysts in one (5.2%) case and multiple cysts in one case with autosomal dominant polycystic kidney disease. They were peripherally located in thirteen, peripelvic in three, and parenchymal in two cases. An average of 3.1 trochars were used for each procedure. The mean operating time was 82.5 +/- 16.7 min (range, 50-135). Neither open conversion nor blood transfusion was necessary. A total of six minor complications were encountered. Mean hospital stay 2.3 +/- 0.9 days (range, 1-4). After a mean follow up of 14.3 +/- 5.9 months (range, 3-24), symptomatic success was achieved in 89.5%, and radiological success was accomplished in 88.2%. An asymptomatic cyst recurrence was observed in one (5.9%) case, and one (5.9%) case with residual pain had new cyst formation at another site of the kidney. CONCLUSIONS: Retroperitoneal laparoscopic cyst decortication using bipolar PlasmaKinetic scissors is a feasible and efficient method, eliminating further fulguration of the base and the margins of the cysts. Operating times are shorter than previously published series and highly satisfactory long-term success rates are achieved.     

Laparoscopic decortication of symptomatic simple renal cysts: 10-year experience from one institution

OBJECTIVE: To assess the long-term results by symptomatic and radiological outcome of laparoscopic decortication of renal cyst, first reported in 1992. PATIENTS AND METHODS: We retrospectively reviewed the records of 36 patients who had a total of 36 laparoscopic decortications at our institution between December 1993 and March 2004. Of these cysts, 30 were peripheral and six were peripelvic cysts; the patients were asked if they had pain or not. Changes of cyst size after decortication were determined by computed tomography and the serial changes of each cyst were evaluated as the percentage of the diameter before surgery. The relationships between radiological and symptomatic outcome or cyst location were examined. RESULTS: Peri-operative morbidity was satisfactory; with a mean (range) follow-up of 67.2 (13-128) months the symptomatic and radiological success rates were 92% (33 of 36) and 81% (25 of 36), respectively. Peripelvic cysts were significantly correlated with radiological failure. Symptomatic improvement was evident by 3 months, while radiological improvement continued for up to 3-4 years after surgery. Seven asymptomatic patients with radiological failure selected a conservative follow-up. CONCLUSIONS: Laparoscopic decortication is safe and provides long-term satisfactory symptomatic results. The radiological improvement was slower than the symptomatic improvement and several cysts remained large, indicating some reduction in volume that was enough to improve the symptoms. This procedure is still challenging for peripelvic cysts in terms of radiological results, yet feasible for the clinical outcome.     

经后腹腔腹腔镜与开放性肾囊肿去顶术疗效比较

目的：比较经后腹腔腹腔镜与开放性肾囊肿去顶术的疗效，并探讨经后腹腔腹腔镜肾囊肿去顶术处理要点。方法：回顾性分析9例经后腹腔腹腔镜肾囊肿去顶术和21例开放性肾囊肿去顶术患者的临床资料，比较两组手术时间、术中失血量和术后住院天数等指标。结果：两组手术时间比较，差异无显著性意义（P＞0.05)，但经后腹腔腹腔镜手术组术中失血量及术后住院时间均显著少于开放性手术组（P＜0.01)。结论：经后腹腔腹腔镜肾囊肿去顶术具有创伤小，患者康复快、疼痛轻的优点，治疗单纯性肾囊肿的疗效明显优于开放性手术。     

直接闭合式经腹膜后腹腔镜肾囊肿去顶术治疗肾囊肿

目的 探讨直接闭合式经腹膜后腹腔镜肾囊肿去顶术治疗效果. 方法 1996年12月～2003年9月,我院采用直接闭合式方法经腹膜后腹腔镜肾囊肿去顶术治疗肾囊11例.腰部髂嵴上2 cm腋中线交界处做小切口1～2 cm,深度至皮下组织,10 mm trocar直接穿刺进入后腹腔,自制注水气囊扩张腹膜后间隙,充分暴露肾囊肿,距离肾实质边缘0.5～1.0 cm处电刀切除囊壁. 结果 10例手术获得成功,手术时间30～100 min,平均77.5 min.术中出血量20～60 ml,平均30.9 ml.1例因暴露囊肿困难中转开放性手术.1例腹膜损伤.术后住院6～9 d,平均7.4 d.7例随访7～26个月,平均15.2月,B超检查肾囊肿无复发. 结论 直接闭合式经腹膜后腹腔镜肾囊肿去顶术创伤小、恢复快、疗效可靠.     

腹膜后腹腔镜肾囊肿去顶术65例报告

目的:总结腹膜后腹腔镜肾囊肿去顶术的手术经验。方法:回顾分析2004年8月至2011年6月为65例患者行腹膜后腹腔镜肾囊肿去顶术的临床资料。其中男44例,女21例;28～77岁,平均53岁。结果:65例均顺利完成腹膜后腹腔镜手术,无一例中转开放。64例行肾囊肿去顶术,1例改行腹腔镜肾部分切除术。手术时间30～120 min,平均42 min。患者均未输血。术中、术后无明显并发症发生。65例患者均获随访,随访3～60个月,行B超或CT检查,均无囊肿或肿瘤复发。结论:腹膜后腹腔镜肾囊肿去顶术治疗单纯性肾囊肿安全、有效,值得推广应用。     

腹腔镜与开放手术行肾囊肿去顶减压术的对比研究

目的:比较腹腔镜与开放手术行肾囊肿去顶减压术的临床疗效。方法:回顾37例腹腔镜单纯性肾囊肿去顶减压术,与38例开放手术的临床资料。结果:术中平均出血量,术后住院时间,术后平均引流量,术后止痛药应用比例腹腔镜组均优于开放组,手术时间、住院费用腹腔镜组与开放组差异无显著性。结论:腹腔镜肾囊肿去顶术具有创伤小,患者康复快,术后住院时间短等优点,是肾囊肿去顶术的首选方法。     

腹腔镜与开放性肾囊肿去顶术的比较

目的 :比较开放性与腹腔镜肾囊肿去顶术的疗效和优点。方法 :采用腹腔镜经腹腔途径对 4 3例肾囊肿患者进行肾囊肿去顶术。并与 2 4例开放性肾囊肿去顶术患者进行比较。结果 :腹腔镜手术时间、术后住院时间均显著少于开放性手术 (P <0 0 1)。术后随访 3～ 12个月 ,未见复发。结论 :经腹腔途径腹腔镜肾囊肿去顶术治疗肾囊肿 ,疗效好 ,患者创伤小 ,术后康复快 ,明显优于开放性手术。     

腹膜后腹腔镜肾囊肿去顶术32例报告

目的 :探讨腹膜后腹腔镜手术治疗肾囊肿的效果。方法 :回顾分析腹膜后腹腔镜手术治疗肾囊肿 32例的临床资料。术中将食指伸入切口内游离各层直达肾下极 ,再放入自行研制的水囊扩张器扩张后腹膜腔。结果 :32例手术均获成功 ,术中出血 10～ 15ml,手术时间 4 0～ 10 0min ,术后住院 2～ 4d ,无 1例发生并发症。结论 :腹膜后腹腔镜手术具有患者创伤小、康复快、住院时间短等优点 ,是行肾囊肿去顶术的首选方法。     

Epidermoid cyst in the renal pelvis

Epidermoid cysts are benign cysts localizingrarely in solid organs with an unclearpathogenesis. A 55 years old woman having anepidermoid cyst in the renal pelvis wasevaluated according to the literature.     

腹腔镜胆囊切除联合肝肾囊肿手术的应用

目的 :探讨腹腔镜胆囊切除 (LC)联合肝囊肿或肾囊肿部分切除减压术的疗效及适用性。方法 :回顾分析 15例LC联合肝囊肿或肾囊肿部分切除减压术的临床资料。结果 :15例LC联合肝、肾囊肿手术均获成功。手术时间 6 0～ 12 0min ,术后未发生严重并发症 ,康复顺利 ,平均住院 3～ 5d。随访 2～ 10月无复发。结论 :LC联合肝囊肿或肾囊肿部分切除减压术疗效肯定 ,操作方便 ,术中视野显露良好 ,患者创伤小 ,康复快 ,术后住院时间短 ,是兼患肝或肾囊肿的胆囊疾病患者最佳的手术方法     

Renal cell carcinoma originating in a renal cyst in a 12-year-old girl

We report a 12-year-old girl with renal cell carcinoma originating in a cyst of the left kidney. Ultrasonography revealed 2 small hyperechoic masses in the luminal side of a cyst. Although hypervascularity was not detected in the cyst by computed tomography, the possibility of malignancy could not be ruled out because of the presence of 2 solid masses. Therefore, partial left nephrectomy was performed. On histopathologic examination, the 2 solid masses within the cyst were found to be renal cell carcinoma. This patient remains disease-free at 4 years after partial nephrectomy.     

后腹腔镜下肾囊肿分型治疗的疗效观察

目的探讨后腹腔镜对单纯肾囊肿进行分型、治疗及其疗效观察。方法回顾性分析71例后腹腔镜手术治疗单纯肾囊肿患者的临床资料，初期23例未作分型直接行囊肿去顶，后期48例对囊肿分型后进行个性化治疗。结果初期23例未作分型处理的患者于术后3个月复查，7例（30．4％）有不同程度的残腔存留和复发；后期48例对囊肿分型（Ⅰ型18例、Ⅱ型21例、Ⅲ型9例）并作相应手术处理的患者术后3个月复查，2例有少量残腔存留（4．16％）。结论后腹腔镜手术治疗肾囊肿疗效确切，对肾囊肿分型并在术中进行个性化处理可提高疗效、降低术后复发率。     

后腹腔镜与开放性肾囊肿去顶术的比较

目的 :探讨后腹腔镜肾囊肿去顶减压术的优越性及临床应用价值。方法 :6例行后腹腔镜下肾囊肿去顶减压术 (后腹腔镜组 ) ,15例行开放性肾囊肿去顶减压术 (开放手术组 ) ,进行比较。结果 :两组手术时间差异无显著性 (P <0 0 5 ) ,而后腹腔镜组术中失血量及术后住院时间均显著少于开放手术组 (P <0 0 5 )。结论 :后腹腔镜肾囊肿去顶减压术具有患者创伤小 ,术中出血少 ,术后康复快等优点 ,是治疗单纯性肾囊肿的理想方法。     

B超引导结合穿刺注药治疗肾囊肿

本文报告采用B超引导经皮穿刺注药治疗肾囊肿25例,取得满意疗效。并就肾囊肿的诊断方法及治疗进行讨论。     

Scarless surgery for a huge liver cyst: A case report

IntroductionSymptomatic or complicated liver cysts sometimes require surgical intervention and laparoscopic fenestration is the definitive treatment for these cysts. We performed minimally invasive surgery, hybrid natural orifice transluminal endoscopic surgery (NOTES) without scarring, for a huge liver cyst.Presentation of caseAn 82-year-old female presented with a month-long history of right upper abdominal pain. We diagnosed her condition as a huge liver cyst by morphological studies. She denied any history of abdominal trauma. Her serum CEA and CA19-9 were normal and a serum echinococcus serologic test was negative. Laparoscopic fenestration, using a hybrid NOTES procedure via a transvaginal approach, was performed for a huge liver cyst because we anticipated difficulty with an umbilical approach, such as single incision laparoscopic surgery (SILS). Her post-operative course was uneventful and she was discharged from our hospital three days after surgery. Pain killers were not required during and after hospitalization. No recurrence of the liver cyst or bulging was detected by clinical examination two years later.DiscussionA recent trend of laparoscopic procedure has been towards minimizing the number of incisions to achieve less invasiveness. This hybrid NOTES, with a small incision for abdominal access, along with vaginal access, enabled painless operation for a huge liver cyst.ConclusionWe report a huge liver cyst treated by hybrid NOTES. This approach is safe, less invasive, and may be the first choice for a huge liver cyst.     

三孔法腹膜后腹腔镜肾囊肿去顶减压术84例报告

目的:探讨三孔法行腹膜后腹腔镜肾囊肿去顶减压术的临床疗效。方法:回顾分析我院为84例肾囊肿患者用三孔法行腹膜后腹腔镜肾囊肿去顶减压术的临床资料,并评价三孔法腹膜后腹腔镜手术中直接扩张后腹膜腔的方法。结果:84例均顺利建立后腹膜腔操作空间,平均用时5.2min,无严重并发症发生。结论:三孔法Trocar直接穿刺、腹腔镜直接分离法操作简单、耗时少、创伤小、安全可靠,是一种值得推广的方法。     

腹腔镜下去顶减压术治疗肾囊肿

目的:评价腹腔镜下治疗肾囊肿的疗效。方法:在腹腔镜下经后腹膜行去顶减压术治疗肾囊肿患者9例。结果:9例患者均获得成功。结论:在腹腔镜下经后腹膜行去顶减压术治疗肾囊肿具有创伤小、恢复快、治疗彻底的特点。