目的:比较和评价后腹腔镜去顶减压术、开放性去顶减压术和穿刺硬化术的治疗单纯性肾囊肿的效果。方法:138例单纯性肾囊肿者中采用后腹腔镜去顶减压术48例,开放性去顶术56例,穿刺硬化术34例。对3种术式的临床疗效、术后恢复及费用等进行对比研究。结果:3组患者在年龄、性别、侧别、随访时间及囊肿大小上差异无统计学意义。腹腔镜组症状消失者72.9%,症状好转者22.9%,无复发;开放手术组症状消失者69.6%,症状好转者26.8%,无复发;穿刺硬化组症状消失者35.3%,症状好转者58.8%,复发29.4%。腹腔镜组术后均未注射止痛剂,平均发热21d,住院35d,伤口疼痛麻木持续1.5个月;开放手术组术后39.3%(22/56)注射止痛剂,平均发热4.4d,住院5.4d,伤口疼痛麻木持续5.6个月;穿刺硬化组术后无注射止痛剂,平均发热0.2d,住院0.8d,伤口疼痛麻木持续0.5月。术后并发症发生率腹腔镜组为6.3%(3/48),主要为肾周血肿和感染;开放手术组为8.9%(5/56),主要为伤口感染、应激性溃疡等;穿刺硬化组为2.9%(1/34),主要为肾周血肿。腹腔镜组和开放手术组费用显著高于穿刺硬化手术组(P lt;0.05)。结论:腹腔镜肾囊肿去顶术疗效确切、复发率低、并发症少、费用高;开放性肾囊肿去顶术疗效确切、复发率低、并发症多、费用高;穿刺硬化术疗效确切、复发率高、并发症少、费用低。在单纯性肾囊肿的治疗中,腹腔镜手术已经成为治疗的金标准,但根据患者的病情和经济社会情况可选择开放手术和穿刺硬化手术治疗。
Citation：
唐铁龙,邓显忠,龚志勇,姜果,鲜述彦,李建勇,曾德朗,崔曙. 单纯性肾囊肿3种手术治疗效果的比较. West China Medical Journal, 2009, 24(5): 1227-1229. doi:
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Copyright © the editorial department of West China Medical Journal of West China Medical Publisher. All rights reserved
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- 1. 王国民,孙立安,徐俊华,等.闭合式经后腹腔腹腔镜肾囊肿去顶[J].中华外科杂志,1998,36:146148.
- 2. LAUCK S P, MCLACHLAN M S F. Aging and simple cysts of the kidney[J]. Br J Rad,1981,54:12.
- 3. RUBENSTEIN S C, HULBERT J C,PHARAND D, et al. Laparoscopic ablation of symptomatic renal cysts[J]. J Urol,1993,150:11031106.
- 4. HULBERT J C, SHEPARD T G, EVANS R F. Laparoscopic surgery for renal cystic disease[J]. J Urol,1992,147:443A..
- 5. MORGAN C, RADER D. Laparoscopic unroofing of a renal cyst[J]. J Urol,1992,148:18351836.
- 6. 那彦群,李双利,郭应禄.腹腔镜切除肾囊肿[J].中华泌尿外科杂志,1994,5:342344.
- 7. DENIS E, NICOLAS F, BEN R N, et al. Laparoscopic surgical treatment of simple cysts of the kidney[J]. Prog Urol,1998,8:195200.
