Technical key points of laparoscopic combined with calyceal lithotomy for the treatment of parapelvic cyst with renal calculi
10.3969/j.issn.1009-8291.2025.07.012
- VernacularTitle:腹腔镜联合肾盏切开取石术同期治疗肾盂旁囊肿合并肾结石的技术要点("大家泌尿网"观看手术视频)
- Author:
Lijun ZHOU
1
;
Jianjun GUO
1
;
Yin YU
1
;
Zhusheng ZHU
1
Author Information
1. 乐山市人民医院泌尿外科,四川乐山 614000
- Publication Type:Journal Article
- Keywords:
parapelvic cyst;
renal calculi;
laparoscope;
calyceal lithotomy
- From:
Journal of Modern Urology
2025;30(7):611-614
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the efficacy,safety,and technical advantages of laparoscopic combined with calyceal lithotomy in the simultaneous treatment of parapelvic cyst with renal calculi.Methods The clinical data of two patients diagnosed with parapelvic cyst and renal calculi in our hospital were retrospectively analyzed.Both patients received transabdominal laparoscopic excision of parapelvic cyst and calyceal lithotomy under general anesthesia.Preoperative CT plus intravenous pyelography(IVP)was performed to localize the calculi within the renal calyx.During operation,the cyst wall was dissected and exposed using an ultrasonic scalpel,followed by incision of the cyst wall,aspiration of cystic fluid,and excision of redundant cyst wall.Methylene blue was instilled through the ureteral catheter to mark the renal pelvis and calyces,followed by incision of the target calyx and extraction of the calculi.The changes of the cysts and calculi were analyzed.Operation time and complications were recorded.Results Both patients were admitted due to recurrent right flank pain as the chief complaint and were diagnosed with right renal multiple calculi complicated with hydronephrosis and parapelvic cysts through preoperative imaging examinations.The parapelvic cyst measured approximately 6.4 cm ×5.3 cm and 4.5 cm × 4.1 cm,respectively.The operations were successfully completed without major complications such as hemorrhage or infection.The operation time was 180 and 125 minutes,respectively.Postoperative ultrasound and abdominal plain film confirmed complete resolution of cysts and calculi.During the 2-year follow-up,both patients experienced complete resolution of flank pain with no recurrence of cysts or calculi.Conclusion Transabdominal laparoscopic combined with calyceal lithotomy is a safe and feasible technique for synchronous treatment of parapelvic cysts with renal calculi,offering advantages such as minimal trauma,rapid postoperative recovery,and low recurrence rates.This procedure should be performed in patients with parapelvic cysts larger than 4 cm.Intraoperative ureteral catheterization with methylene blue infusion is utilized to delineate the renal pelvis and calyces,which is combined with preoperative imaging findings to assist in precise stone localization.
