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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 report the initial experience of transcatheter drainage and drainage of renal cysts under transurethral ureteroscopic NOTES ureteroscopy and to evaluate its safety and feasibility. Methods: Three cases of renal cysts diagnosed by B ultrasound, CT and IVU were treated by incision and drainage of transurethral NOTES renal cysts. 2 cases on the left and 1 case on the right. Intraoperative transurethral ureteroscopy into the collection system, looking for cysts; can not find those who assist in the B-positioning. Holmium laser to the cyst wall at the thinnest for “ten ” word incision to expand the incision to 1.5 ~ 2.0cm. Indwelling F7 ureteral double J tube, the proximal end of stay in the cyst. Results: All 3 cases were successful. One patient went to the renal pelvis to look for cysts and two patients under ultrasound guidance. The median operative time 45 (30 ~ 125) min, no major bleeding, peripheral organ injury, septic shock and other complications. Postoperative review B ultrasound or CT showed that the diameter of renal cysts are reduced by more than 1/2. Conclusion: Transurethral transurethral resection and drainage of renal cyst with transvaginal NOTES ureteroscopy is safe, minimally invasive, simple and feasible, with fewer complications, faster recovery, short-term curative effect and excellent cosmetic results. It is suitable for the treatment of endogenous renal cysts .