超声引导输尿管软镜钬激光切开内引流术治疗肾盂旁囊肿
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摘要
目的探讨超声引导输尿管软镜钬激光切开内引流术治疗肾盂旁囊肿的有效性和安全性。方法回顾性分析2015年3月～2018年9月14例肾盂旁囊肿的临床资料,单发肾盂旁囊肿1例,双侧肾盂旁囊肿2例,肾盂旁囊肿伴同侧肾结石11例。囊肿直径3. 0～5. 5 cm,平均4. 2 cm。彩超引导下用钬激光对集合系统的囊壁行开窗引流,留置双J管引流2～3个月。结果 14例手术均成功。手术时间11～48 min,平均26 min。术中、术后无严重并发症发生。术后随访2～12个月,平均6个月,9例囊肿消失,其余5例囊肿由术前3. 8～5. 5 cm缩小至1. 5～3. 0 cm,未见囊肿复发。结论超声引导下输尿管软镜钬激光切开内引流术治疗肾盂旁囊肿安全,疗效确切。
Objective To evaluate the efficacy and safety of ultrasound-guided flexible ureteroscopic holmium laser incision and internal drainage in the treatment of parapelvic cysts. Methods We retrospectively analyzed clinical data of 14 cases of renal pelvis-side cysts from March 2015 to September 2018. There were 1 case of solitary renal pelvis cyst,2 cases of bilateral parapelvis cyst,and 11 cases of parapelvis cyst combined with ipsilateral nephrolithiasis. The diameter of the cyst was 3. 0-5. 5 cm,with an average of 4. 2 cm. Under the guidance of color ultrasonography,the wall of the collection system was opened and drained by holmium laser,and a double-J tube was retained for drainage for 2-3 months. Results The operation was successful in all the 14 cases. The operation time was 11-48 min( mean,26 min). No serious complications occurred during or after the operation. Follow-ups for 2-12 months( mean,6 months) showed that the cysts disappeared in 9 cases,and reduced from 3. 8-5. 5 cm preoperatively to 1. 5-3. 0 cm after operation in the remaining 5 cases. No recurrence of cysts was found. Conclusion Ultrasound-guided flexible ureteroscopic holmium laser incision and internal drainage for the treatment of parapelvic cysts is safe and effective.
Objective To evaluate the efficacy and safety of ultrasound-guided flexible ureteroscopic holmium laser incision and internal drainage in the treatment of parapelvic cysts. Methods We retrospectively analyzed clinical data of 14 cases of renal pelvis-side cysts from March 2015 to September 2018. There were 1 case of solitary renal pelvis cyst,2 cases of bilateral parapelvis cyst,and 11 cases of parapelvis cyst combined with ipsilateral nephrolithiasis. The diameter of the cyst was 3. 0-5. 5 cm,with an average of 4. 2 cm. Under the guidance of color ultrasonography,the wall of the collection system was opened and drained by holmium laser,and a double-J tube was retained for drainage for 2-3 months. Results The operation was successful in all the 14 cases. The operation time was 11-48 min( mean,26 min). No serious complications occurred during or after the operation. Follow-ups for 2-12 months( mean,6 months) showed that the cysts disappeared in 9 cases,and reduced from 3. 8-5. 5 cm preoperatively to 1. 5-3. 0 cm after operation in the remaining 5 cases. No recurrence of cysts was found. Conclusion Ultrasound-guided flexible ureteroscopic holmium laser incision and internal drainage for the treatment of parapelvic cysts is safe and effective.
引文
1 Gadelmoula M,Kurkar A,Shalaby MM.The laparoscopic management of symptomatic renal cysts:a single-centre experience.Arab J Uml,2014,12:173-177.
2 Bas O,Nalbant I,Can SN,et al.Management of renal cysts.JSLS,2015,19(1):e2014.00097.
3那彦群,叶章群,孙颖浩,等.中国泌尿外科疾病诊断治疗指南.北京:人民卫生出版社,2014.365-370.
4 Basiri A,Hosseim SR,Tousi VN,et al.Ureteroscopic management of symptomatic,simple parapelvic renal cyst.J Endourol,2010,24(4):537-540.
5 Agarwal MM,Hemal AK.Surgical management of renal cystic disease.Curr Urol Rep,2011,12(1):3-10.
6俞蔚文,张大宏,何翔,等.输尿管软镜下钬激光切开内引流术治疗肾盂旁囊肿的临床研究.中华泌尿外科杂志,2013,34(7):489-492.
7杨嗣星,吴旭,廖文彪,等.输尿管软镜下钬激光内切开引流术治疗肾囊性疾病的安全性及疗效.中华泌尿外科杂志,2016,37(1):17-20.
8叶章群,吴柏霖.关注泌尿系结石的治疗进展.中华泌尿外科杂志,2012,33(1):6-9.
9杨文增,周可义,赵春利,等.穿刺针辅助输尿管软镜处理肾下盏特殊位置结石的有效性.实用医学杂志,2016,32(4):631-633.
10张佳义,李明,万恩明,等.组合式输尿管软镜配合手助肋脊角托举治疗下组肾盏结石.中华腔镜泌尿外科杂志(电子版),2015,9(2):108-111.
11杨文增,周可义,赵春利,等.穿刺针配合输尿管软镜处理难治性肾下盏结石效果观察.微创泌尿外科杂志,2016,5(4):253-254.
12赵春利,周可义,赵春利,等.经皮微通道同期治疗肾盂旁囊肿合并肾盂输尿管连接部狭窄的疗效观察.中国微创外科杂志,2017,17(9):808-810.
13郭丰富,邵志强,王广健,等.经皮肾囊肿穿刺2μm激光切开内流术治疗肾盂旁囊肿.中华医学杂志,2012,92(2):122-123.
14蒋祥新,蔡万松,闻立平,等.输尿管软镜鞘直视置入法钬激光碎石术一期治疗肾结石的临床分析.中华泌尿外科杂志,2016,37(12):932-935.
15何士尧,丁克文.输尿管软镜鞘外持续引流在输尿管软镜碎石术中的应用(附55例报告).国际泌尿系统杂志,2018,38(1):89-91.
2 Bas O,Nalbant I,Can SN,et al.Management of renal cysts.JSLS,2015,19(1):e2014.00097.
3那彦群,叶章群,孙颖浩,等.中国泌尿外科疾病诊断治疗指南.北京:人民卫生出版社,2014.365-370.
4 Basiri A,Hosseim SR,Tousi VN,et al.Ureteroscopic management of symptomatic,simple parapelvic renal cyst.J Endourol,2010,24(4):537-540.
5 Agarwal MM,Hemal AK.Surgical management of renal cystic disease.Curr Urol Rep,2011,12(1):3-10.
6俞蔚文,张大宏,何翔,等.输尿管软镜下钬激光切开内引流术治疗肾盂旁囊肿的临床研究.中华泌尿外科杂志,2013,34(7):489-492.
7杨嗣星,吴旭,廖文彪,等.输尿管软镜下钬激光内切开引流术治疗肾囊性疾病的安全性及疗效.中华泌尿外科杂志,2016,37(1):17-20.
8叶章群,吴柏霖.关注泌尿系结石的治疗进展.中华泌尿外科杂志,2012,33(1):6-9.
9杨文增,周可义,赵春利,等.穿刺针辅助输尿管软镜处理肾下盏特殊位置结石的有效性.实用医学杂志,2016,32(4):631-633.
10张佳义,李明,万恩明,等.组合式输尿管软镜配合手助肋脊角托举治疗下组肾盏结石.中华腔镜泌尿外科杂志(电子版),2015,9(2):108-111.
11杨文增,周可义,赵春利,等.穿刺针配合输尿管软镜处理难治性肾下盏结石效果观察.微创泌尿外科杂志,2016,5(4):253-254.
12赵春利,周可义,赵春利,等.经皮微通道同期治疗肾盂旁囊肿合并肾盂输尿管连接部狭窄的疗效观察.中国微创外科杂志,2017,17(9):808-810.
13郭丰富,邵志强,王广健,等.经皮肾囊肿穿刺2μm激光切开内流术治疗肾盂旁囊肿.中华医学杂志,2012,92(2):122-123.
14蒋祥新,蔡万松,闻立平,等.输尿管软镜鞘直视置入法钬激光碎石术一期治疗肾结石的临床分析.中华泌尿外科杂志,2016,37(12):932-935.
15何士尧,丁克文.输尿管软镜鞘外持续引流在输尿管软镜碎石术中的应用(附55例报告).国际泌尿系统杂志,2018,38(1):89-91.