| Objective:By collecting the cases of parapelvic cysts in our hospital,consulting the relevant data and comparing the clinical data,the curative effects of ureteroscopic incision and internal drainage of parapelvic cysts and retroperitoneal laparoscopic decompression of parapelvic cysts were compared.Methods:The clinical data of 78 patients with parapelvic cysts treated in the first affiliated Hospital of Zhengzhou University from January 2012 to January 2018 were analyzed retrospectively.All the 78 patients were treated surgically and followed up after operation.among them,40 cases(group A)were treated with retroperitoneal laparoscopic decompression of parapelvic cysts,and 38 cases(group B)were treated with ureteroscopic incision and internal drainage of parapelvic cysts.The preoperative basic data,perioperative related indexes and postoperative follow-up data of the two groups were compared.combined with the data type,?~2 test or group t test was used.Results:1.The operation was successful in all 78 patients.There were no serious complications during and after operation,and no conversion to open surgery.In group B,4 patients were complicated with ipsilateral renal calculi,all of which were treated with renal calculi at the same time.2.The average operation time was(62.3±12.4)min and(54.78±7.44)min(P<0.05)in posterior laparoscopy group and ureteroscopy group,respectively.The mean intraoperative blood loss was(48.1±5.4)ml and(15.7±4.0)ml(P<0.01),respectively.The mean postoperative intestinal recovery time was(32.5±5.7)hours and(14.4±3.5)hours(P<0.01),respectively.The average postoperative bed rest time was(1.9±0.4)days and(1.1±0.6)days(P<0.01),respectively.The average postoperative hospital stay was(5.7±1.0)days and(3.5±0.6)days(P<0.05),respectively.The perioperative indexes of ureteroscopy group were significantly better than those of posterior laparoscopy group.3.In the retroperitoneal surgery group,1 case underwent repair because of the injury of the renal pelvis,and 1 case in the ureteroscopy group developed high fever after operation.The incidence of operative complications was 2.5%and 2.63%in the two groups,respectively.there was no significant difference in the incidence of operative complications between the two groups(P>0.05).4.The patients were followed up regularly for 12 months to 24 months,and 78patients were followed up.All the patients with clinical symptoms were improved and the renal function was normal.Imaging examination showed that the cysts disappeared in 26 patients in the posterior laparoscopy group,and the cysts in 12patients were reduced by more than 1/2 compared with those before operation,the effective rate was 95%.In ureteroscopy group,22 cases of cysts disappeared and 13cases of cysts shrank by more than 1/2 compared with those before operation.The effective rate was 92.1%.There was no significant difference in the effective rate between the two groups(P>0.05).One case(2.5%)recurred in the posterior laparoscopy group,and 2 cases(5.26%)of cyst recurrence in ureteroscopy group,there was no significant difference in recurrence rate between the two groups(P>0.05).Conclusion:1.Retroperitoneal laparoscopic decompression of parapelvic cysts,as a minimally invasive operation,is effective,safe and feasible.it has many advantages,such as small trauma,rapid recovery of patients,short hospitalization time and so on.2.Compared with retroperitoneal laparoscopic renal parapelvic cyst decompression,holmium laser cyst incision and internal drainage under ureteroscope has the advantages of less surgical injury and faster postoperative recovery.it is a safe and effective way to treat the disease.3.The two surgical methods have their own limitations.for different patients,the condition should be fully evaluated before operation,and the appropriate surgical program should be selected to achieve better treatment results. |
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