摘要
目的:报告经尿道NOTES输尿管软镜下肾囊肿内切开引流术的初步经验,并评价其安全性和可行性。方法:对3例经B超、CT和IVU检查确诊的肾囊肿患者行经尿道NOTES肾囊肿内切开引流术治疗。左侧2例,右侧1例。术中经尿道置入输尿管软镜至收集系统,寻找囊肿;无法寻及者,辅助以B超定位。予钬激光于囊肿壁最薄处作"十"字切开,扩大切口至1.5～2.0cm。留置F7输尿管双J管,将其近端留置于囊肿内。结果:3例手术均顺利。1例进镜至肾盂后寻及囊肿,2例在超声引导下定位。中位手术时间45(30～125)min,无大出血、周围脏器损伤、感染性休克等并发症发生。术后复查B超或CT示肾囊肿直径均缩小1/2以上。结论:经尿道NOTES输尿管软镜下肾囊肿内切开引流术具有安全、微创、简便可行、并发症少、恢复快、近期疗效确切、美容效果极佳等优点,适合内生性肾囊肿的治疗。
Objective：To describe the initial clinical experience of pure Transurethral NOTES for fenestration and drainage treatment of renal cyst, and evaluate its feasibility and safety：Method：From May to August 2012, two female patients and a male patient with renal cyst underwent pure Transurethral NOTES for fenestration and drainage treatment. The median age was 28.6 （range 22 to 40） years. In this group, one renal cyst was on the right side and two on the left. All cases were confirmed by B ultrasound, CT scan and IVU. The median diameter of renal cyst was 6.2（range 5.2 to 7.1）cm. After induction of general anesthesia, flexible ureter scope was tran- surethrally introduced into renal collect system. Renal cyst was found by I3 ultrasound guide when necessary. A crisscross incision was cut by Holmium laser to 1.5-2.0 cm, and a F7 double J stent was positioned with the proxi- mal end coiled in the cyst cavity, which was removed after 4 weeks. Result： All procedures were successfully com- pleted. One cyst was found by flexible ureter scope and the others were found by B ultrasound guide. The median operation time was 60 （range 30 to 125） min. There was no intraoperative or postoperative complication. The di- ameter of cyst decreased at least 1/2 during follow-up （3 to 6 months）. Conclusion： Pure Transurethral NOTES for fenestration and drainage treatment of renal cyst is safe, feasible, minimal invasive and cosmetic. It is worth selecting the method to treat peripheral renal, cyst.
出处
《临床泌尿外科杂志》
2013年第2期81-83,共3页
Journal of Clinical Urology
基金
国家高技术研发计划(863计划)项目(编号2012AA021100)
江西省"赣鄱英才555工程"领军人才培养计划项目
江西省科技厅重大科技支撑计划项目(编号20121BBG70032)
关键词
经自然腔道内镜手术
经尿道途径
肾囊肿
natural orifice transluminal endoscopic surgery
transurethral surgery
renal cyst
