Darby C R, Cranston D, Raine A E, Morris P J
Nuffield Department of Surgery, John Radcliffe Hospital, Oxford, UK.
Br J Surg. 1991 Mar;78(3):305-7. doi: 10.1002/bjs.1800780313.
Forty patients with end-stage renal failure, who had undergone simultaneous bilateral native nephrectomy before a subsequent renal transplant operation, were reviewed with particular reference to the indications and surgical approach for bilateral nephrectomy and to the complications of the procedure. The main indications for bilateral nephrectomy are hypertension resistant to medical therapy, persistent symptomatic renal infection, severe renal protein loss and occasionally polycystic kidneys or bilateral renal tumours. In this consecutive series of 40 patients both kidneys were removed because of chronic pyelonephritis with reflux (n = 28), glomerulonephritis with reflux (n = 9) and uncontrolled hypertension (n = 3). Surgical morbidity was less in patients who had bilateral nephrectomy performed through bilateral vertical lumbotomy incisions. There was no surgical mortality.
对40例终末期肾衰竭患者进行了回顾性研究，这些患者在随后的肾移植手术前接受了同期双侧自体肾切除术，特别参考了双侧肾切除术的适应证、手术方法以及该手术的并发症。双侧肾切除术的主要适应证为药物治疗难以控制的高血压、持续性症状性肾感染、严重肾蛋白丢失，偶尔也适用于多囊肾或双侧肾肿瘤。在这连续的40例患者中，因慢性肾盂肾炎伴反流（n = 28）、肾小球肾炎伴反流（n = 9）和无法控制的高血压（n = 3）而切除了双侧肾脏。通过双侧腰部垂直切口进行双侧肾切除术的患者手术并发症较少。无手术死亡病例。
