输尿管软镜下钬激光内切开治疗肾盂旁囊肿的临床分析

目的探讨输尿管软镜下钬激光内切开治疗肾盂旁囊肿的安全性及临床疗效。 方法回顾性分析我院自2017年9月至2020年7月应用输尿管软镜钬激光内切开引流治疗的32例肾盂旁囊肿患者的临床资料。男21例，女11例，年龄35~68岁。囊肿大小3.5 cm×3.0 cm~7.0 cm×5.0 cm，平均（5.0±0.8）cm。均为单侧肾囊肿（BosniakⅠ型29例，BosniakⅡ型3例）。其中单发囊肿24例，多发囊肿5例，多囊肾1例，合并同侧结石2例。有8例合并不同程度肾积水。分析术前、术后囊肿变化情况、手术时间、术后住院天数、并发症等情况。 结果本组患者手术均顺利完成，无中转腹腔镜或开放手术。手术时间为22~68 min，平均（43±12） min，术后住院3~6 d（平均3.8±0.7）d，术后定期随访3~6个月。22例囊肿术后消失，9例囊肿术后缩小，1例多囊肾术后囊肿未见明显变化。8例肾积水患者积水均消失。手术相关并发症为18.75%，5例为ClavienⅠ级，1例为ClavienⅡ级。 结论输尿管软镜下钬激光内切开治疗肾盂旁囊肿具有创伤小、恢复快等优点，是安全、有效治疗方式，但远期疗效有待进一步随访观察。

Clinical analysis of flexible ureteroscope with holmium laser incision for treatment of renal parapelvic cyst

ObjectiveTo evaluate the safety and clinical efficacy of flexible ureteroscopy (RIRS) with holmium laser incision for treatment of renal parapelvic cyst. Methods32 cases with renal parapelvic cyst after RIRS with holmium laser incision from September 2017 to July 2020 were reviewed.There were 21 males and 11 females and the age was 35-68 years. The size of parapelvic cyst ranged from (3.5 cm×3.0 cm) to (7.0 cm×5.0 cm), mean (5.0±0.8) cm. All cases were unilateral parapelvic cyst (Bosniak Ⅰ cysts were in 29 cases and Bosniak Ⅱ in 3 cases). In which, 24 cases got single cysts, 5 cases got multiple cysts, 1 polycystic kidneys and 2 cases with renal calculi. There were 8 cases with hydronephrosis of different degrees. Preoperative and postoperative cyst changes, operation time, postoperative hospital stay, complications were analyzed. ResultsAll surgeries were performed successfully. Operation time was 22-68 min, mean (43±12) min. The postoperative hospital stay was 3-6 (3.8±0.7) days. After follow-up of 3-6 months, the cysts disappeared in 22 patients and size reduced in 9 patients. There was no obvious change in 1 patient of polycystic kidney cyst after operation. Hydronephrosis disappeared in 8 patients. Complication occurred in 6 patients (18.75%), 5 were Clavien Ⅰ grade and 1 was Clavien Ⅱ grade. ConclusionsFlexible ureteroscopy with holmium laser incision is a safe and effective method for the treatment of parapelvic cyst, but the long-term efficacy needs further follow-up observation.