探讨输尿管软镜下钬激光切开内引流治疗肾盂旁囊肿的疗效和安全性。

分析2014年1月至2017年1月河南省立院行输尿管软镜下钬激光切开内引流治疗的16例肾盂旁囊肿患者临床资料。男10例，女6例，年龄40~71岁，平均54岁，术前影像学检查诊断为肾盂旁囊肿，均为单侧肾盂旁囊肿，囊肿挤压肾盂、肾盏，囊肿表面正常肾皮质较厚，均为Bosniak I类囊肿，囊肿直径3~7 cm，合并同侧或对侧单纯性肾囊肿2例，合并同侧肾结石1例。

16例患者手术均成功完成，无中转开放手术。手术时间29~60 min，平均40 min；术后住院5~7 d，平均6 d。术后定期随访3个月~2年，13例囊肿消失，2例囊肿直径较术前缩小1/2以上，1例术后复发再次行输尿管软镜下切开引流术治愈。

输尿管软镜钬激光切开引流术治疗经合理选择的肾盂旁囊肿创伤小，安全有效，是治疗此类囊肿的理想方法。

To explore the efficacy and safety of flexible ureteroscopic intrapelvic drainage with holmium laser in the treatment of parapelvic cyst.

The clinical data of 16 patients treated with flexible ureteroscopic incision and drainage using holmium laser between January 2015 and January 2017 were summarized in Henan Provincial Hospital. Ten male and six female patients were enrolled eventually, ranging from 40 to 71 years old, with an average of 54 years old. Pretheroputic evaluation included uranalysis, ultrasonography, intravenous or CT urography (IVU or CTU) and CT angiography (CTA). All of the parapelvic cysts were unilateral and the diameters were 3-7 cm. Bosniak I cysts were indentified in all 16 cases.Two cases were accompanied with simple renal cysts (SRC) ipsilaterally or contralaterally,and one case with renal calculus.

The operations were successful in all 16 patients without conversions to open surgery. The average operative time was 40 min (range 29-56 min). The average postoperative hospital stay was 6 days (range 5-7 days). After a follow-up of 3-24 months, the cysts disappeared in 13 patients and size reduced more than one half in 2 patients. One patient was detected with recurrent parapelvic cyst 1 year postoperatively and was cured by repeated procedure.

Flexible ureteroscopic intrapelvic drainage with holmium laser is minimally invasive, safe and effective, is an optimal option in the treatment of parapelvic cyst.