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目的探讨耻骨上辅助经脐微双孔腹腔镜技术(SAU-LEMDS)治疗肾囊肿的安全性、可行性和有效性。方法本组26例,男16例,女10例。年龄18~70岁,平均年龄(48.5±2.5)岁。均为单发肾囊肿,其中左侧18例,右侧8例;囊肿位于肾上极背侧3例、肾上极腹侧3例、肾中部背侧2例、肾中部腹侧3例、肾下极背侧6例、肾下极腹侧9例。囊肿最大径5.8~12.0 cm,平均(7.5±2.0)cm。全麻,健侧70°卧位,脐缘置入两个5 mm Trocar及操作器械,自耻骨联合患侧阴毛覆盖区置入一5 mm Trocar及腹腔镜。手术方法同普通腹腔镜肾囊肿去顶减压术,标本自脐部任一Trocar取出,无需延长切口。结果全部手术均成功。手术时间20~65min,平均(30±5.6)min。失血量5~20ml,平均(10±2.5)ml。住院时间3~6 d,平均(4±0.5)d。术后随访1~3个月,平均(2±0.5)个月,囊肿无复发,术后切口愈合良好,手术瘢痕隐蔽,美容效果佳。结论 SAU-LEMDS技术治疗肾囊肿安全可行,可降低经脐单孔腹腔镜技术(U-LESS)手术难度,且具有良好的美容效果;可作为现阶段U-LESS的过渡手术,值得临床推广应用。
Objective To investigate the safety, feasibility and effectiveness of suprapubic assisted transurethral double-port laparoscopy (SAU-LEMDS) in the treatment of renal cysts. Methods The group of 26 patients, 16 males and 10 females. Aged 18 to 70 years old, mean age (48.5 ± 2.5) years. All of them were single renal cysts, of which 18 were on the left and 8 were on the right. The cysts were located in the dorsal renal superior pole in 3 cases, the upper pole ventral in 3, the dorsal middle renal in 2, the medial middle ventral in 3, 6 cases of inferior renal pelvis and 9 cases of superficial ventral pelvis. The largest diameter of cysts 5.8 ~ 12.0 cm, with an average (7.5 ± 2.0) cm. General anesthesia, contralateral 70 ° supine, umbilical cord into the two 5 mm Trocar and operating equipment, pubic area from the pubic symphysis pubic area into a 5 mm Trocar and laparoscopy. Surgical methods with ordinary laparoscopic renal cyst decompression surgery, the specimen removed from any Trocar umbilical, without extending the incision. Results All the surgeries were successful. The operation time was 20 ~ 65min, with an average of (30 ± 5.6) min. Blood loss 5 ~ 20ml, the average (10 ± 2.5) ml. Length of stay 3 ~ 6 d, an average of (4 ± 0.5) d. The patients were followed up for 1 to 3 months, with an average of (2 ± 0.5) months, no recurrence of cysts, good incision healing, concealed surgical scars and good cosmetic results. Conclusions The SAU-LEMDS technique is safe and feasible for the treatment of renal cysts, which can reduce the difficulty of U-LESS surgery and has a good cosmetic effect. It can be used as a transitional operation of U-LESS at this stage and is worthy of clinical application .