摘要
目的 探讨输尿管软镜联合钬激光治疗单纯性肾盂旁囊肿的近期临床疗效及安全性.方法 回顾性选择分析2012年1月至2016年6月收治的25例单纯性肾盂旁囊肿患者的临床资料,男15例,女10例,年龄22 - 65岁,平均48岁,直径3.5 -5.8 cm,平均4.2 cm,单侧单发肾盂旁囊肿23例,单侧多发肾盂旁囊肿2例.术前均经超声、静脉肾盂造影及CT三维重建等确诊.术前预置输尿管支架管1周后于全麻下行输尿管软镜下钬激光内切开引流术,直视下切开集合系统淡蓝色凸起的囊肿壁,切开范围1 -2 cm^2,留置输尿管支架管于囊肿内引流4周.结果 24例手术成功,1例中转为腹腔镜手术,无术中及术后严重并发症发生.手术时间30 - 65 min,平均42 min,术后住院4-7 d,平均5d.术后随访6- 36个月,20例囊肿消失,3例囊肿明显缩小,1例失访,均未见囊肿复发或继发病变.结论 输尿管软镜联合钬激光疗肾盂旁囊肿具有自然、微创、术后恢复快等优势,手术安全,近期疗效确切,但需严格选择适应证.
Objective To investigate the clinical efficacy and safety of flexible ureteroscopy combinded with the holmium laser for simple parapelvic renal cysts.Methods A retrospective study was conducted to analyse the clinical data of 25 patients with simple parapelvic cyst from January 2012 to June 2016.Fifteen men and 10 women were included,ranging from 22 to 65 years old,with an average of 48 years old.The diameters of the cysts were 3.5 - 5.8 cm,and the average diameter was 4.2 cm.All cases were unilateral,with singe parapelvic cyst in 23 cases,and multiple parapelvic cysts in 2 cases.Type-B ultrasonography,intravenous urography （IVU） and three-dimensional reconstruction of computed tomography （CT） were used for checking and making a definite diagnosis.Ureteral stenting was performed 1 week before the operation in each patient to facilitate ureteroscopic access.All patients had undergone holmium laser incision and drainage of parapelvic cysts by using flexible ureteroscope under general anaesthesia.With direct vision,the cyst wall on the obvious parapelvic compression site was cut.The diameter of the cyst wall cut was about 1 -2 cm^2.Meanwhile,the double-J stent was indwelled for 4 weeks.Results In 25 cases of operation,24 cases were successful,1 case was converted to laparoscopic surgery,no major complications occurred intraoperatively and postoperatively.The mean operation time was 42 min （30 -65 min） and the mean hospital stay was 5 days （4 -7days）.Time of follow-up was 6 -36 months.The results of follow-up showed that the cyst disappeared in 20 cases,and the diameter of the cyst in 3 cases was reduced by more than half,and one case lost.Neither cyst recurrened or secondary disease occurred.Conclusions Flexible ureteroscopy combined with the holmium laser has advantages of natural,minimally invasive and short hospital stay,which is safe with exact short-term efficacy.However,the patients need to be screened strictly.
作者
杨金辉
孙建涛
郝彤彤
吕文伟
康延杰
张寒
Yang Jinhui;Sun Jiantao;Hao Tongtong(Department of Urology, Luoyang Central Hospital Af- flitated to Zhengzhou University ,Luoyang 471000, China)
出处
《国际泌尿系统杂志》
2018年第3期391-394,共4页
International Journal of Urology and Nephrology
关键词
囊肿
肾盂
输尿管镜
激光
固体
钬
Cysts
Kidney Pelvis
Ureteroscopes
Lasers
Solid - State
Holmium
