Benchekroun A, Lachkar A, Soumana A, Faik M, Marzouk M, Farih M H, Belahnech Z
Clinique Urologique A, Service du Pr A. Benchekroun, CHU Ibn Sina, Rabat, Maroc.
Ann Urol (Paris). 1999;33(1):19-24.
The kidney is a rare site of hydatid disease. It remains clinically silent for a long time and only presents at the stage of complications. The diagnosis is essentially radiological. Renal hydatid cyst (RHC) raises therapeutic problems due to its complications, which sometimes make kidney-preserving cyst resection surgery difficult. The authors report a series of 45 cases of RHC treated in their department during a 20-year period. This series consisted of 27 men and 18 women with a mean age of 47 years (26-80 years). The clinical features were dominated by pain (80%), flank mass (42%), hydaturia (22%), haematuria (13%), urinary tract infection (6%), hypertension (3%). IVU, performed in all patients, showed calcifications in 35% of cases, renal tumour syndrome in 71% of cases and silent kidney in 22% of cases. Surgery was usually performed via a lumbar incision (75%) or a BARAYA incision (15%). Treatment consisted of 18 cyst roof resections (40%), 6 pericystectomies (13%), partial nephrectomy in 2 cases (4%) and total nephrectomy in 18 cases (40%). The postoperative course was marked by urinary fistula in two patients and one death at the 2nd postoperative month related to associated renal sarcoma. The objective of this study is to analyse the epidemiological, pathological and therapeutic features of this disease, which still constitutes a public health problem in Morocco.
肾脏是包虫病的罕见发病部位。它在很长一段时间内临床上并无症状,仅在出现并发症阶段才会表现出来。诊断主要依靠影像学检查。肾包虫囊肿(RHC)因其并发症而引发治疗难题,这些并发症有时会使保留肾脏的囊肿切除术变得困难。作者报告了他们科室在20年期间治疗的45例RHC病例。该系列包括27名男性和18名女性,平均年龄47岁(26 - 80岁)。临床特征以疼痛(80%)、侧腹肿块(42%)、包虫尿(22%)、血尿(13%)、尿路感染(6%)、高血压(3%)为主。所有患者均进行了静脉尿路造影(IVU),结果显示35%的病例有钙化,71%的病例有肾肿瘤综合征表现,22%的病例为静息肾。手术通常通过腰部切口(75%)或巴拉亚切口(15%)进行。治疗方式包括18例囊肿顶部切除术(40%)、6例囊肿外切除术(13%)、2例部分肾切除术(4%)和18例全肾切除术(40%)。术后病程中,两名患者出现尿瘘,一名患者在术后第二个月因合并肾肉瘤死亡。本研究的目的是分析这种在摩洛哥仍构成公共卫生问题的疾病的流行病学、病理学和治疗特征。