CAJ | 학술논문

目的：探讨经皮穿刺硬化治疗后复发肾囊肿行后腹腔镜手术治疗时机的选择及手术技巧。方法肾囊肿患者1例，查体发现右肾上部囊肿约7×7 cm2大小，行右肾囊肿穿刺并注射无水乙醇硬化治疗。穿刺后3个月复查彩超提示：右肾上部囊肿约4×4.5 cm2大小，考虑囊肿复发，为求手术治疗入院。入院后全麻下行后腹腔镜右肾囊肿去顶术。结果术中见右肾上部约5×6 cm2范围肾脂肪囊粘连于肾表面，无典型囊肿表现，不能确定此处是否为囊肿。以自制注射针于此处穿刺抽出囊液证实为囊肿，并经注射针向囊内注水30 ml后囊肿体积增大，确定囊肿边界，切除囊壁，手术顺利。术后病人恢复顺利，病理提示为单纯性囊肿，随访半年无复发。结论经皮穿刺硬化治疗后肾囊肿周围粘连明显。建议复发患者手术时机选择在硬化治疗后6个月，复发肾囊肿周围粘连严重难以辨认时可自制注射针回抽及注水帮助辨认囊肿。
목적：탐토경피천자경화치료후복발신낭종행후복강경수술치료시궤적선택급수술기교。방법신낭종환자1례，사체발현우신상부낭종약7×7 cm2대소，행우신낭종천자병주사무수을순경화치료。천자후3개월복사채초제시：우신상부낭종약4×4.5 cm2대소，고필낭종복발，위구수술치료입원。입원후전마하행후복강경우신낭종거정술。결과술중견우신상부약5×6 cm2범위신지방낭점련우신표면，무전형낭종표현，불능학정차처시부위낭종。이자제주사침우차처천자추출낭액증실위낭종，병경주사침향낭내주수30 ml후낭종체적증대，학정낭종변계，절제낭벽，수술순리。술후병인회복순리，병리제시위단순성낭종，수방반년무복발。결론경피천자경화치료후신낭종주위점련명현。건의복발환자수술시궤선택재경화치료후6개월，복발신낭종주위점련엄중난이변인시가자제주사침회추급주수방조변인낭종。
Objective To explore retroperitoneal laparoscopic surgery treatment timing and surgical techniques of recurrence after percutaneous puncture sclerotherapy of renal cyst .Methods Patients with renal cyst found about upper right kidney cyst size 7 × 7 cm2 by physical examination ,was given right renal cyst puncture and injection of anhydrous ethanol sclerotherapy .3 months after the piercing color ultrason ography displayed :about upper right kidney cyst size 4 × 4 .5 cm2 ,considering cyst re‐currence .General anesthesia downlink retroperitoneum laparoscopic renal cyst to top right .Results In about 5 × 6 cm2 above right kidney in a range of renal adipose capsule adhesion on surface of the kidney ,no typical cysts ,cannot determine whether here for cysts .With self‐made puncture needle in this spare fluid confirmed as cyst ,The needle to pouch cyst after 30 ml water injection volume increase ,determine the cyst boundary ,excision of cystic wall ,operation smoothly .Postoperative patients re‐covery smoothly ,The pathological hint for simple cyst .Follow‐up for half a year without recurrence .Conclusion After percu‐taneous puncture sclerotherapy adhesion obviously around the cyst .Suggest patients with recurrence 6 months after operation timing hardening treatment .Recurrence of renal cyst adhesions around when it is difficult to identify serious homemade needle back to pumping and injection to help identify the cyst .