最近6年間における経皮的腎嚢胞穿刺術の経験
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1)超音波ガイド下に62症例,65腎,69嚢胞に対し,経皮的腎嚢胞穿刺術を施行した。2)嚢胞内容液が血性でなく,嚢胞造影上,造影剤の漏出や尿路系との交通がない症例に対し置換率60～70%,上限120mlを目安として無水エタノールを注入した。3)注入後2ヵ月～5年7ヵ月の経過観察期間において平均縮小率95.1%と良好な結果をえた。4)重篤な合併症や副作用はみられなかったUltrasound-guided renal cyst puncture of 69 renal cysts was performed in our department, between April, 1986 and March, 1992. The indications for this procedure consisted of cysts over 4 cm in diameter and those of less than 4 cm in diameter with caliceal or pelvic distortion and compression. Fifty-four cysts were instilled with dehydrated ethanol, 10 cysts with minocycline, one cyst with 50% dextrose as a sclerosing agent, and four cysts underwent only aspiration of the cyst fluid. We instilled dehydrated ethanol when the aspirated fluid was not bloody and there existed no extravasation of the contrast medium or communication between the cyst cavity and the urinary tract. The instilled volume of dehydrated ethanol ranged from 8 to 400 ml (average: 72.8 ml), equivalent to 35.0-100% (average: 62.1%) of the aspirated volume. Retention time was 20 minutes, the follow-up period was 2-67 months (mean follow-up period: 13.7 months), and the reduction rate of the cyst volume was 60.0-100% (average: 96.2%). There were no major complications due to puncture or dehydrated ethanol instillation. Ultrasound-guided renal cyst puncture was shown to be a safe non-surgical approach and a useful method of treating renal cysts.
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