超声引导注射亚甲蓝在输尿管软镜处理肾盂旁囊肿术中的应用

doi:10.19558/j.cnki.10-1020/r.2020.05.004

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摘要 目的：探讨超声引导注射亚甲蓝注射液定位囊肿在输尿管软镜肾盂旁囊肿治疗中应用的安全性和有效性。方法：回顾性分析2017年2月–2019年12月收治的13例输尿管软镜定位困难的肾盂旁囊肿的临床资料,其中男6例,女7例。年龄27~65岁,平均（53.4±9.5）岁。均为单侧单发肾盂旁囊肿,囊肿直径2.9~6.4 cm,平均（5.0±1.2）cm。13例患者囊肿均压迫肾盂肾盏,5例并发同侧肾结石,2例存在腰痛症状。13例患者均行肾盂旁囊肿经尿道输尿管软镜激光切开内引流术,术中患者均取斜仰卧截石位。13例患者输尿管软镜直视下无法明确定位囊肿,均应用超声引导向囊腔内注射亚甲蓝进行染色定位,再以钬激光对被染色的肾盂旁囊肿进行切开内引流,开窗直径1~2 cm,使囊腔与肾盂相通,并于囊腔内留置双J管。结果：手术均成功,术中平均囊肿处理时间（17.9±5.6）min,术中均未出现并发症,术后1例合并结石的患者出现发热,经抗生素治疗后体温降至正常,余患者术后未出现并发症,2例腰痛患者术后腰痛消失。术后平均住院（4.1±3.1）d。术后随访3~12个月,11例（84.6%）囊肿消失,2例（15.4%）囊肿明显缩小,未见囊肿复发。结论：在输尿管软镜处理肾盂旁囊肿过程中,对于输尿管软镜下无法明确定位囊肿位置的肾盂旁囊肿,应用超声引导注射亚甲蓝对囊肿进行染色定位安全可行,短期疗效确切。

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	蔡旺海
	朱庆国
	叶烈夫
	李涛
	林榕城
	林友成
	杨泽松
	胡敏雄

关键词 ：肾盂旁囊肿, 输尿管软镜, 超声, 亚甲蓝

Abstract：Objective： To investigate the safety and effectiveness of ultrasound-guided injection of methylene blue locating cysts in flexible ureteroscopy （fURS） for treatment of parapelvic cysts. Methods： A retrospective study was performed on the clinical data of 13 cases of parapelvic cysts, which were difficult to locate with flexible ureteroscopy, from February 2017 to December 2019. There were 6 males and 7 females, with an average age of （53.4±9.5） years old. All lesions were unilateral parapelvic renal cysts, with a cyst diameter of 2.9-6.4 cm （mean 5.0±1.2 cm in diameter）. The cysts of 13 cases oppressed the renal pelvis and calyces, 5 patients had ipsilateral renal stones, and 2 patients were symptomatic with flank pain. All patients were treated with transurethral fURS internal cyst drainage. The operation was done in all patients in the oblique supine lithotomy position. The cyst could not be clearly positioned under fURS. The methylene blue was injected into the cyst cavity for staining and positioning, and then the peripelvic cyst was decorticated with holium laser to drain the cyst to the pelvis. A 1-2 cm window was created, the cyst cavity is communicated with the renal pelvis, and the proximal end of a double-J stent was placed in the cystic cavity to facilitate internal drainage. Results： All operations were successfully done with no intraoperative complications. One patient with stones developed fever after the operation, and his body temperature dropped to the normal level after antibiotic treatment. The mean operation time was （17.9±5.6） min. The remaining patients did not have complications after the operation. The mean hospital stay was （4.1±3.1） days. After 3-12 months of follow-up, the cysts in 11 patients （84.6%） disappeared, those in 2 patients （15.4%） were significantly reduced, and no patient experienced recurrence. Conclusions： In the process of flexible ureteroscopy for the treatment of parapelvic cysts, it is safe and feasible to use ultrasound-guided injection of methylene blue to stain and position the cysts.

Key words： peripelvic cyst flexible ureteroscopy ultrasound methylene blue

收稿日期: 2020-05-03

ZTFLH:

R692

通讯作者: 叶烈夫,yeiefu@126.com;朱庆国,zuqinguo@163.com

引用本文:

蔡旺海, 朱庆国, 叶烈夫, 李涛, 林榕城, 林友成, 杨泽松, 胡敏雄. 超声引导注射亚甲蓝在输尿管软镜处理肾盂旁囊肿术中的应用[J]. 微创泌尿外科杂志, 2020, 9(5): 305-309.
CAI Wanghai, ZHU Qingguo, YE Liefu, LI Tao, LIN Rongcheng, LIN Youcheng, YANG Zesong, HU Minxiong. Application of ultrasound-guided injection of methylene blue locating cyst wall in flexible ureteroscopy for treatment of parapelvic cyst. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2020, 9(5): 305-309.

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http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1618.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2020/V9/I5/305

[1] CAMARGO AHLA, COOPERBERG MR, ERSHOFF BD, et al.Laparoscopic management of peripelvic renal cysts: University of California, San Francisco, experience and review of literature. Urology, 2005,65(5):882-887.
[2] ZHAO Q, HUANG S, LI Q, et al.Treatment of parapelvic cyst by internal drainage technology using ureteroscope and Holmium laser. West Indian Med J, 2015,64(3):230-235.
[3] YU W, ZHANG D, HE X, et al.Flexible ureteroscopic management of symptomatic renal cystic diseases. J Surg Res, 2015,196(1):118-123.
[4] ZHU ZW, CHEN HQ, CUI Y, et al.Long-term outcome after flexible ureteroscopy with Holmium laser for simultaneous treatment of a single renal cyst and ipsilateral renal stones. J Int Med Res, 2019,47(8):3601-3612.
[5] KANG N, GUAN X, SONG LM, et al.Simultaneous treatment of parapelvic renal cysts and stones by flexible ureterorenoscopy with a novel four-step cyst localization strategy. Int Braz J Urol, 2018,44(5):958-964.
[6] MAO X, XU G, WU HF, et al.Ureteroscopic management of asymptomatic and symptomatic simple parapelvic renal cysts. BMC Urol, 2015,15:48.
[7] WANG Z, ZENG XY, CHEN C, et al.Methylene blue injection via percutaneous renal cyst puncture used in flexible ureteroscope for treatment of parapelvic cysts: a modified method for easily locating cystic wall. Urology, 2019,125:243-247.
[8] LUO Q, ZHANG X, CHEN H, et al.Treatment of renal parapelvic cysts with a flexible ureteroscope. Int Urol Nephrol, 2014,46(10):1903-1908.
[9] AMIS EJ, CRONAN JJ.The renal sinus: an imaging review and proposed nomenclature for sinus cysts. J Urol, 1988,139(6):1151-1159.
[10] LANG EK.Renal cyst puncture and aspiration: a survey of complications. AJR Am J Roentgenol, 1977,128(5):723-727.
[11] CAMACHO MF, BONDHUS MJ, CARRION HM, et al.Ureteropelvic junction obstruction resulting from percutaneous cyst puncture and intracystic isophendylate injection: an unusual complications. J Urol, 1980,124(5):713-714.
[12] 袁慧星,周炳炎,刘夏铭,等.超声引导下输尿管软镜钬激光切开内引流治疗肾盂旁囊肿疗效观察.微创泌尿外科杂志,2017,6(5):292-294.
[13] 陈苏,赵纯雄,陈洪波.输尿管软镜联合钬激光同期治疗肾结石合并肾盂旁囊肿的疗效分析.微创泌尿外科杂志,2018,7(5):306-309.
[14] 杨嗣星,吴旭,廖文彪,等.输尿管软镜下钬激光内切开引流术治疗肾囊性疾病的安全性及疗效.中华泌尿外科杂志,2016,37(1):17-20.