比較氣球擴張與直接零度內視鏡剝離後腹腔行後腹腔鏡水泡除頂術台北市立聯合醫院經驗
鄭玠豪1,2 、賴昱維1,2 、薛又仁1,2、 黃建榮1, 2 、邱逸淳1,2 、陳修聖1,2、 邱文祥1,2
台北市立聯合醫院外科部泌尿外科1
國立陽明大學醫學院泌尿學科2
Compare balloon dilatation with direct zero degree telescope dissection of retroperitoneal space for unroofing of renal cyst in Taipei City Hospital experience
Jehow cheng、Yu-Wei Lai、Thomas Y. Hsueh 、Andy C. Huang、 Yi-Chun Chiu、 Shiou-Sheng Chen、 Allen W. Chiu
Divisions of Urology, Department of Surgery, Taipei City Hospital, Taiwan
National Yang-Ming University, School of Medicine, Taiwan
Purpose:
To Compare the results of balloon dilatation with direct zero degree telescope dissection of retroperitoneal space for unroofing of renal cyst
Patients and Methods:
Total sixteen patient had undergone retroperitoneoscopic cyst unroofing at our hospital during January 2010 to December 2014 were collected and analyzed. Sixteen patients with symptomatic simple renal cysts had undergone unroofing of the cyst with balloon dilatation(BD) in nine cases and direct zero degree telescope dissection(DZDTD) in eight others. Three trocars (10 mm, 10 mm and 5 mm) were inserted in all the procedure. A 2 cm flank muscle-split incision was made and retroperitoneoscopy was performed through the same incision in all the procedure. Then, the cyst was unroofed
Results:
The mean operative time was 64.4 minutes in the DZDTD group and 85.6 minutes in the BA group. The In the DZDTD group, the mean postoperative stay was 4 days, and the time to feeding was 9.4 hours. In the BD group, the mean postoperative stay was 4.6 days, and the time to feeding was 37.4 hours.
Estimated blood loss in the DZDTD group was 56 mL. Estimated blood loss in the BD group was 46mL. No case required conversion to open surgery. No significant intraoperative complication was noted. Only No patient need blood transfusion . The postoperative complication rate was 0%. Most complications were minor and did not need specific treatment.
Conclusions:
DZDTD and BD techniques for unroofing of renal cysts are safe, effective and minimally invasive. DZDTD is easy to perform and seem to be a more time-saving procedure when compared to BD. DZDTD seem be feasible and effective to treat symptomatic simple renal cysts.