腘窝囊肿关节镜术后复发原因与对策（开放获取）

Causes and countermeasures of recurrent popliteal cysts following arthroscopic resection

摘要:

腘窝囊肿是一种常见的疾病，手术方式众多，以往常采用开放式手术切除囊肿，但术后复发率高。如何减少关节镜术后复发仍是目前研究的热点。腘窝囊肿术后复发常受到解剖、原发病因、手术操作和患者自身因素等多种情况影响。关节镜下关节内疾病处理、囊肿引流有效；合理选择关节镜入路是手术成功的关键；术中同时将囊壁切除，可进一步减少术后囊肿复发率，但要注意防范膝后血管神经损伤等严重并发症。本文结合相关文献与病例，着重对腘窝囊肿发病机理、术后复发解剖学因素与关节内疾病相关性、诊断要点、关节镜手术技巧、关键点与术中注意事项进行阐述，以提高其诊断治疗水平，减少术后复发的发生率。

Abstract:

Popliteal cyst is a common disease, and there are many surgical methods. Previously, open resection to remove the cyst was the common treatment method, whereas with high postoperative recurrence rate. How to reduce the recurrence after arthroscopic resection remains the focus of current research. The recurrence of popliteal cyst after operation is often affected by many factors such as anatomy, primary cause, surgery and patient's own factors. Arthroscopic intraarticular disease management and cyst drainage are effective. Reasonable selection of arthroscopic approach is the key to successful operation. The cyst wall resection during the operation can further reduce the chance of the postoperative recurrent cyst, but attention should be paid to prevent the serious complications of the vascular and nerve injury of the posterior knee. In combination with relevant literature and a case, this paper focuses on the pathogenesis of popliteal cyst, the postoperative recurrence related anatomical factors and intra-articular diseases, diagnostic issue, arthroscopic surgical skills, key points and intraoperative pitfall, so as to improve the diagnosis and treatment and reduce postoperative recurrent cyst.