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目的探讨经腹膜后腹腔镜肾囊肿去顶手术的临床疗效。方法 30例患者采用气管插管全麻,气囊扩张建立后腹膜腔,暴露背侧腰大肌、腹侧腹膜返折和上方膈肌脚等标志并找出并暴露肾囊肿,用超声刀距肾实质3～5mm将囊壁去顶切除,对这些资料进行总结分析。结果 30例肾囊肿顺利切除,手术时间30～60min,平均45min。术中出血量5～60ml,平均35ml。术后住院3～6d。29例病理报告为良性病变,1例怀疑囊性腺癌。30例随访1～22个月,1例术后1个月经B超复查仍有直径1.5cm囊肿,余未见复发。可疑腺癌者已随访1年,胸片及肝肾B超无肿瘤生长及转移灶。结论经腹膜后腹腔镜肾囊肿去顶术是治疗肾囊肿安全、有效的方法。
Objective To investigate the clinical effect of retroperitoneal laparoscopic renal cyst removal surgery. Methods Thirty patients underwent tracheal intubation general anesthesia, balloon dilatation to establish retroperitoneal cavity, exposing signs of dorsal psorama, ventral peritoneal palsy and upper diaphragmatic muscle, and to identify and expose renal cysts. 3 ~ 5mm to the apical resection of the wall, to summarize the analysis of these data. Results 30 cases of renal cysts were successfully removed, the operation time was 30 ~ 60min, an average of 45min. Intraoperative bleeding 5 ~ 60ml, an average of 35ml. After hospitalization 3 ~ 6d. 29 cases of pathological reports of benign lesions, 1 case of suspected cystic adenocarcinoma. Thirty patients were followed up for 1 ~ 22 months. One patient had a cyst of 1.5 cm in diameter at one month after operation, and no recurrence was found. Suspected adenocarcinoma has been followed up for 1 year, chest X-ray and liver and kidney without tumor growth and metastasis. Conclusion Retroperitoneal laparoscopic renal cyst debridement is a safe and effective method for the treatment of renal cysts.