Single-port transumbilical laparoscopic surgery for the treatment of 10 patients with bilateral renal cysts
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摘要: 目的：探讨经脐单孔腹腔镜治疗双侧单纯性肾囊肿的临床应用价值。方法：回顾性分析对本院自2010年2月~至2011年12月收治的10例双侧单纯性肾囊肿患者临床资料，所有均施行经脐单孔腹腔镜下双侧肾囊肿去顶减压术。其中男4例，女6例，年龄47~70岁，囊肿直径（7.70±1.54） cm。本组患者9例双侧囊肿位于肾脏腹（外）侧，仅1例单侧囊肿位于肾盂旁，均适合此手术方式。于脐部作一2~3 cm切口建立自制单孔操作通道，切开结肠旁沟处的侧腹膜，游离并暴露囊肿。在距肾实质约5 mm处用超声刀将大部分囊肿壁完整切除，撤出腹腔镜，保留操作通道，改变患者体位并以同样方式处理对侧囊肿。结果：9例顺利完成单孔腹腔镜手术，1例因囊肿位置特殊，术中分离较困难，在合适部位增加一5 mm操作通道。手术时间平均（91.7±24.7） min，术中平均出血（38.9±25.8） ml，平均术后住院（3.5±1.7） d，术后平均留置引流管2.1 d。术后随访3~12个月，脐部切口愈合良好，囊肿无复发，无脐疝等相关手术并发症产生。结论：采用自制经脐单孔多通道腹腔镜治疗双侧肾囊肿安全可行，手术时间缩短，术后恢复快，术后切口瘢痕隐蔽，具有良好的微创和美容效果，为双侧肾脏病变提供新的手术治疗方式。Abstract: Objective: To evaluate the clinical application value of one-stage single-port transumbilcal laparoscopic surgery for the treatment of bilateral renal cysts.Method: From Feb. 2010 to Dec. 2011, ten cases patients with bilateral simple renal cysts were treated by self-made single-port transumbilcal laparoscopic renal Cystectomy. 4 patients were male and 6 patients were female, aged from 47 to 70 years. The cysts diameter were (7.70±1.54) cm. The renal cysts were located in the ventral(or ventrolateral) side in this group of patients, one case's cyst located in the peripelvic, suitable for the laparoscopic surgery. Establishing the single-port operation channel through a 2-3 cm umbilical incision, then cut the side peritoneal and separated to expose the cyst and cut the whole cyst wall about 5 mm away from the renal parenchyma by the Ultrasonic scalpel. Keeping the operation channel and changed the position to deal with the other side in the same way.Result: Nine single-port laparoscopic operations were completed successfully, and one case added a 5 mm operation channel in a appropriate site because the location of the cyst was difficult to separate. The mean operative time was (91.7±24.7) min, mean blood loss was (38.9±25.8) ml, the mean postoperative hospital stay were(3.5±1.7) d, and the mean duration of drainage catheter was 2.1 d. The patients were followed up 3-12 months, during which no complications occurred, and the incision healed well.Conclusion: The self-made laparoscopic single-site transumbilical surgery for bilateral simple renal cysts is safe and feasible, scar hidden, has good cosmetic results and a new clinical treatment method is provided for bilateral renal diseases.
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Key words:
- laparoscopy /
- single-port /
- renal cyst /
- therapy
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