Laparoscopic Cyst Decompression Combined With Renal Capsule Decortication Surgery For Autosomal Dominant Polycystic Kidney Disease

Objective:A retrospective study was undertaken to evaluate the application and efficacy of laparoscopic cyst decompression combined with renal capsule decortication in patients with autosomal dominant polycystic kidney disease(ADPKD).Methods:From January 2004 to January 2011,20 patients (Experimental group,11 males and 9 females) with adult polycystic kidney disease were treated with laparoscopic cyst decompression combined with renal capsule decortication and the data were reviewed. Indexes such as mean operating time, loss of blood, postoperative hospital stay, drainage, renal function before and after operation, blood pressure, and lumbar pain were analyzed with SPSS for statistical test.At the same time, the same indexes of 50 patients (The control group,28 males and 22 females) treated with laparoscopic cyst decompression only between January 2004 and January 2011 were analyzed.Results:In group 1, the operations were completed smoothly in all the 20 cases. The operation time was 65-194 min (mean,106±15.4 min), and the blood loss was 20-180 ml (mean,39 ml). Patients began out of bed activities in 1～2 days after operation and were discharged from hospital at 4～10 days. All the pathological findings were in accordance with changes of ploycystic kidney. Follow up examinations were carried out for 2～24 months (mean,16.7±2.4 months). Renal function and back pain was relived in all cases. In 13 patients with a high blood pressure, the systolic pressure was decreased by 18～30 mm Hg. The size of the kidneys and the largest cysts which were treated became smaller. In group 2, the operations were completed smoothly in all the 50 cases. The operation time was 658～155 min (mean,85±10.7 min), and the blood loss was 10～230 ml (mean,27 ml). Patients began out of bed activities in 1-2 days after operation and were discharged from hospital at 4～9 days. All the pathological findings were in accordance with changes of ploycystic kidney. Follow up examinations were carried out for 2～24 months (mean, 15.3±3.9 months). Renal function and back pain was relived in all cases. In 38 patients with a high blood pressure, the systolic pressure was decreased by 12～26 mm Hg. The size of the kidneys and the largest cysts which were treated became smaller, too.Conclusions:Treatment of aparoscopic cyst decompression combined with renal capsule decorticationin is a safe and effective method in thetreatment of ADPKD, being worthy of clinical recommendation...