Renal cystectomy

Treatment of diseases: simple renal cyst renal cyst Indication Renal cystectomy is available for: 1. Isolated multi-atrial renal cysts with impaired renal function. 2. Peripheral cysts, renal peritoneal cysts cause urinary tract obstruction. 3. A large renal cyst or cyst with infection, bleeding, stones. 4. Kidney hydatid cysts. Contraindications There are no absolute contraindications. However, patients with benign cysts who have severe bleeding tendency may be relatively contraindicated. Radical cysts should be treated with cancerous renal cysts. Preoperative preparation 1. Preoperative pyelography confirmed the cyst site and its anatomical relationship. 2. When the kidney capsule is combined with cancer, it is necessary to prepare for partial nephrectomy or radical nephrectomy. 3. Use antibiotics when combining infections. Surgical procedure 1. The incision is made of the eleventh intercostal or oblique oblique incision. Free kidneys, and the relevant imaging examination of preoperative pyelography, to determine the location of the cyst, to determine the extent of cyst removal. 2. After exposing the cyst to detect the cyst, the kidney capsule is cut here, and it is peeled off in the upward and downward directions to reveal the cyst. 3. Excision of the cyst The tissue wall is lifted with tissue forceps, and the cyst is removed between the cyst wall and the renal parenchyma and completely removed. The bleeding point of the wound was peeled off with a 4-0 chrome gut suture. If the lesion has been removed to the renal pelvic funnel, it should be sutured with absorbable threads. 4. For the diagnosis of renal hydatid cysts, the cysts should be removed first, and the same amount of 10% formaldehyde solution should be injected from the original needle. After 10 minutes, the fluid in the capsule should be drained. 5. Cut the outer wall of the capsule and bluntly separate the inner capsule. After the inner capsule is removed, the residual cavity of the outer capsule is killed with hydrogen peroxide or formaldehyde solution, and then washed with physiological saline. The inner wall of the residual cavity is sutured from the deep and shallow sides. The inner sulcus is closed to the outer capsule to eliminate the residual cavity, or the pedicled fat flap is used to fill the residual cavity to prevent infection. complication 1. Bleeding: Patients with renal cyst resection often have mild hematuria in the early stage. Generally, they can stop on their own within a few days without special treatment. Renal wounds are completely hemostasis, and secondary bleeding rarely occurs. 2. Urinary fistula: Renal cystectomy, especially in the renal pelvis cyst and renal pelvis, surgical resection deep into the renal pelvis funnel, may leak urine. Generally, it can self-heal in 1 week. If you have not healed for a long time, you should further examine the reasons and deal with them according to the specific circumstances. 3. Infection: bleeding, urinary fistula and infection often affect each other and cause mutual influence, and simple renal cysts rarely occur. Once the infection or the hydatid cyst is contaminated in the surgical field, the patient often suffers from low back pain, tenderness in the kidney area, high fever, and poor antibacterial therapy, which can rapidly develop into renal empyema and abscess around the kidney. Therefore, once the above symptoms occur, the diagnosis should be made as soon as possible, and the drainage should be performed in time.