CAJ | 학술논문

目的探讨免气囊分离后腹膜间隙腹腔镜下治疗肾囊肿的疗效.方法 80例诊断为肾囊肿的患者随机分为2组.对照组40例,常规行后腹腔镜下肾囊肿去顶减压；观察组40例,免气囊分离后腹膜间隙组织,腔镜下直接分离后腹膜间隙及肾脂肪囊抵达肾囊肿部位,作囊肿去顶减压术.统计2组手术时间,出血量及术后并发症.结果 80例均顺利完成手术,无一例术中转开放手术.对照组手术时间42～78 min,平均(57.0±1.7) min,观察组手术时间30 ～ 62 min,平均(42.0±1.2) min,差异有统计学意义(P＜0.05).对照组术中失血35 ～ 68 ml,平均(50.0±1.5)ml,观察组失血20 ～ 50 ml,平均(27.0±1.2)ml,2组比较差异有统计学意义.对照组平均下床活动时间为术后(4.2±0.2)d,而观察组为(1.6±0.1)d,2组比较差异有统计学意义.术后平均随访6个月,囊肿均无复发.结论免气囊分离后腹膜间隙腹腔镜下囊肿去顶减压术安全有效,可缩短手术时间,术中失血少,术后恢复快.
목적 탐토면기낭분리후복막간극복강경하치료신낭종적료효.방법 80례진단위신낭종적환자수궤분위2조.대조조40례,상규행후복강경하신낭종거정감압；관찰조40례,면기낭분리후복막간극조직,강경하직접분리후복막간극급신지방낭저체신낭종부위,작낭종거정감압술.통계2조수술시간,출혈량급술후병발증.결과 80례균순리완성수술,무일례술중전개방수술.대조조수술시간42～78 min,평균(57.0±1.7) min,관찰조수술시간30 ～ 62 min,평균(42.0±1.2) min,차이유통계학의의(P＜0.05).대조조술중실혈35 ～ 68 ml,평균(50.0±1.5)ml,관찰조실혈20 ～ 50 ml,평균(27.0±1.2)ml,2조비교차이유통계학의의.대조조평균하상활동시간위술후(4.2±0.2)d,이관찰조위(1.6±0.1)d,2조비교차이유통계학의의.술후평균수방6개월,낭종균무복발.결론 면기낭분리후복막간극복강경하낭종거정감압술안전유효,가축단수술시간,술중실혈소,술후회복쾌.
Objective To investigate the clinical effect of unseparated retroperitoneal space for the laparoscopic renal cysts treatment.Methods Eighty cases of renal cysts were randomly divided into two groups:the control group (40 cases,the traditional method for the laparoscopic renal cysts treatment) and the observation group (40 cases,the retroperitoneal approach that the retroperitoneal space was not separated,the laparoscopic directly separated renal adipose capsule and unroofed renal cysts).Statistical data of operation time,bleeding volume and post-surgery complications was included.Results All operations were successfully finished and none of them was referred for the open operation.The mean time of operation in the control group was (57.0 ± 1.7 ) minutes,the observation group was (42.0 ± 1.2 ) minutes,there was statistically significant difference between two groups ( P ＜0.05).The mean hemorrhage in operation in the control group was (50.0 ± 1.5) ml,that in the observation group was (27.0 ± 1.2) ml,there also was statistically significant difference between two groups.Patients in the observation group could get out of bed ( 1.6 ± 0.1 ) days average while the control group was (4.2 ± 0.2) days,there was statistically significant difference.All cases had a followed up for 6 months,none of them was relapsed.Conclusion Unseparated retroperitoneal space for the Laparoscopic renal cysts unroofing and decompression can be used safely and effectively because of less operative time,less blood loss and more rapid recovery than avarege.