Clinical Investigation On The Treatment Of Simple Renal Cysts With Laparoscopy

Objective To evaluate the methods and clinical value of laparoscopic renal cyst decortication. To compare the therapeutic effects and advantages of laparoscopic versus open renal cyst unroofing.Methods The 128 cases treated with laparoscopic renal cyst decortication were reviewed retrospectively in the fields of indications to operation, preoperative preparation, approaches, postoperative complications and how to accomplish operation. 128cases were treated by laparoscopic operation with the general anesthesia. 115 cases in transperitoneal and 21 cases in retroperitoneal .All the cases were compared with 86 cases treated by open renal cyst decortication.Then the clinical advantages ,operation time ,blood loss,the durations of hospitalization after operation,etc were studied.Result 70 cases have pains in the back .After opretion the pain of the back resolved in 72.9%(51/70)and improved in 21.4%(15/70) in the laparoscopic group,and in the open surgical group71.2%(37/52) and 21.6%(11/52) (P>0.05).There was no recurrence in both groups. Mean hospitalizations day was 3.62±1.53 days in the laparoscopy group, whereas it was 9.72 ± 2.15 days in the open surgical group. Post operative fever last day mean of 2.1 and 3.2 days in the two groups respectively (P<0.05). There was no need of analgesia afte rlaparoscopy while 37.2%(32/86) of the patients needed analgesia injection after open surgery(P<0.05). Incisional pain or numbness lasted a mean of 2 months in the laparoscopy group and with a mean of 9months in the open surgery group. The incidence of complication was 1.6%(2/128) in the laparoscopic group being mainly perirenal hematoma and hemorrhage in the operative field. In the open surgery group the complications were infection of incisional wound and infection of lung with amorbidity of 8.1%(7/86). 128 cases were followed up froml to 24 months after surgery. All cases were satisfied with the clinical effect and no obvious complications were found.Conclusion The laparoscopic renal cyst decortication has more advantages of less trauma,quicker recovery,less suffering and complications than open renal cyst decortication and has more practical values, it may take place of open renal cyst decortication. Sufficient preoperative preparations are indispensable to all cases and the approaches must be selected correctly in the light of the habit of operators.