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目的:探讨经腹腔途径腹腔镜下囊肿去顶治疗成人多囊肾的临床疗效。方法:50例(67侧)均行腹腔镜下囊肿去顶术,其中17例双侧(5例一次同期完成,12例分期完成)囊肿去顶术,33例单侧去顶术。观察术后临床症状及肾功能改善情况。结果:50例(67侧)手术均获成功,无中转开放手术。手术顺利,平均手术时间85 min,平均术中出血量45 ml。术后2例出现肾周引流漏尿,每天引流量200~600 ml,10天后消失;余48例恢复顺利,未发生明显外科并发症。术后病理均为多囊肾,未见恶性变。42例术后平均随访12(6~30)个月,腰痛减轻26/31例;血压正常10/22例,较术前有所下降12/22例;BUN及Cr正常8/18例,较术前有所下降10/18例;复查彩超肾脏术后体积较术前均明显缩小。结论:经腹腹腔镜下多囊肾去顶减压视野清晰、创伤小、恢复快,可延缓疾病发展、改善肾功能,是治疗成人多囊肾较理想的方法。
Objective: To investigate the clinical effect of transabdominal laparoscopic cyst debridement on adult polycystic kidney disease. Methods: Laparoscopic cyst debridement was performed in 50 cases (67 sides), of which 17 cases were bilateral (5 cases were completed in one time and 12 cases were completed), and 33 cases were unilateral demyelination. To observe the clinical symptoms and improvement of renal function. Results: All the 50 cases (67 sides) had successful operation and no transfer to open surgery. The operation was smooth with an average operation time of 85 min and an average intraoperative blood loss of 45 ml. Peripheral drainage and leakage of urine occurred in 2 cases after operation. The drainage volume per day was 200-600 ml and disappeared after 10 days. The remaining 48 cases recovered smoothly without significant surgical complications. Postoperative pathology were polycystic kidney disease, no malignant change. 42 patients were followed up for an average of 12 (6 ~ 30) months, 26/31 patients with lumbago reduced; 10/22 patients with normal blood pressure, 12/22 patients decreased compared with preoperative; BUN and Cr normal 8/18 patients 10/18 cases decreased preoperatively; color ultrasound examination after surgery volume were significantly reduced compared with preoperative. Conclusion: The transabdominal laparoscopic polycystic kidney descendations clear vision, less trauma, rapid recovery, can delay the development of the disease, improve renal function, is an ideal method for the treatment of adult polycystic kidney disease.