| Background and purpose:Polycystic kidney disease is one of the most common autosomal genetic diseases which make kidney damage to the structure and function by a series of bilateral and progressive increases renal cysts.According to different genetic pattern,PKD can be divided into autosomal dominant polycystic kidney disease and autosomal recessive polycystic kidney disease.ARPKD was particularly prevalent in infants and children, the majority of early mortality,very few survive to adulthood.ADPKD in clinical is more common,often asymptomatic early,with the pathology of performance for the development of low back pain,hematuria,urinary tract infection and slow the progress of renal dysfunction.With effective renal units can be further reduced eventually to the development of renal failure.But no special polycystic kidney disease has been the ideal method of treatment,how to treat polycystic kidney disease has also become the focus of attention of everyone present.With the improvement of living standards,people's requirements of the quality of health care services also has been increasing in minimally invasive surgery has been gaining popularity and has become the main trends in the development of science. Laparoscopic renal cyst decortication as a minimally invasive treatment method has been subject to medical workers and patients with concern,and gradually applied to clinical work.The purpose of this study through LRCD is find the clinical value in the treatment of polycystic kidney disease. Methods:1.Including and excluding standard:(1)Including standard:Clinical diagnosis of polycystic kidney disease,one of≥5 cm diameter cyst or cyst is less than 5cm,but the combined lumbar abdominal pain,high blood pressure or gross hematuria,and other symptoms.(2)Excluding standard:①coagulation disorder;②patients with serious heart and lung disease;③symptoms of acute peritonitis;④renal cyst infection exist2.Assemble the data:Statistics operation group in the patient's age,surgery time(min),bleeding volume (ml),after preoperative blood pressure(mmhg),after preoperative creatinine(mg/dl), blood urea nitrogen(mmol/1)postoperative indwelling drainage tube time(d),after anus exhaust time(h),get out of bed after Time(h),length of stay(d),the incidence of complications,such as the various indicators.Study the efficacy of LRCD in the treatment of polycystic kidney disease can achieve the effect of minimally invasive,as well as short-term renal function and blood pressure control roleAll the data were analyzed by SPSS11.0 for windows.We chose different statistical method depended on the different data information.Result:From January 2003 to November 2007 all we done 47 LRCD were successful,no interim open surgery.22 routine bilateral laparoscopic surgery,25 unilateral routine laparoscopic surgery,and to the side of the first symptoms of serious surgery. Common symptoms include high blood pressure,kidney stones,pain,abdominal mass, urinary tract infection,hematuria,such as anemia.1.Patients after surgery and recovery statistics,the operation time of bilateral laparoscopic surgery,surgical operation time of 50～145 min average of 80.2±33.2 min.Unilateral laparoscopic surgery,the operation time of 105 to 300 min with an average of 189.1±63.9 min.Blood loss 10-200 ml,91.3±103.3ml average.Exhaust anus after time:15-72(35.4±20.0)hours.Get out of bed Time:18-120(43.1±25.5) hours.Hospitalized after 2-11(5.6±2.6)days.After three days of fever in 12 cases, accounting for 25.5%.2.Blood pressure changes:comparison with the preoperative blood pressure after one week and after January of changes in blood pressure,blood pressure than the preoperative found significantly decreased(P＜0.01).3.Renal function:To compare preoperative renal function(Cr,Bun)and after one week and after the changes in January,found that more preoperative renal function significantly improved(P＜0.01).Conclusion:1.Intraperitoneally,a laparoscopic approach for the treatment of cystic top polycystic kidney disease,less blood loss,quicker recovery of gastrointestinal function after,a few short days after hospitalization,less complication rate,and reflects the good trauma patients small,less bleeding,rapid recovery of minimally invasive principle. LRCD is a good method of the surgical treatment of PKD.2.Polycystic kidney disease is caused by a chromosomal genetic diseases,yet no effective treatment measures.The current treatment is surgical treatment and medication.Due to renal parenchymal damage,and many patients developed symptoms of hypertension,increased sexual cyst,renal parenchymal damage have increased,eventually to renal failure.The laparoscopic renal cysts to the top of minimally invasive surgery as a way to improve hypertension and renal situation in the medium-term effects of their short notable.Therefore,the use of laparoscopic renal cysts as early as possible to the top of dealing with polycystic kidney disease, cystic lifting oppression,it is important to protect the renal parenchyma.
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