Featherstone Neil, Boddy Su-Anna, Murphy Feilim Liam
St George's Hospital, London, UK.
Pediatr Surg Int. 2011 Nov;27(11):1227-31. doi: 10.1007/s00383-011-2975-4. Epub 2011 Sep 28.
The indications for partial or total nephrectomy for urological reasons are not clearly documented in the paediatric surgical literature and there are only a limited number of publications on this subject.
In order to clarify the situation in our centre, we reviewed our own indications for nephrectomy over a 20-year period.
Medical records of patients who underwent nephrectomy for urological and oncological causes between May 1990 and October 2010 at our centre were retrospectively reviewed. Indications for nephrectomy were noted. Renal function was noted for urological cases.
A total of 357 nephrectomies were undertaken; out of these, 241 cases were for urological causes and 116 for oncological reasons. The majority of total nephrectomies were performed for multicystic dysplastic kidneys, reflux nephropathy, pelvi-ureteric junction obstruction and dysplasia. Eighty-seven patients exhibited no function at the time of nephrectomy. Of the remainder, 17 had <5% function, 18 had 5-10% function, 5 had 10-15% function and 2 patients had 15-20% function.
This is the largest series of nephrectomies in the paediatric surgery literature to date. The majority of nephrectomies were undertaken for urological conditions with relative renal function of <10% and could not have been usefully preserved in situ. We suggest that kidneys with >10% function should not be routinely removed.
小儿外科文献中未明确记载因泌尿系统原因行部分或全肾切除术的指征，关于该主题的出版物数量有限。
为明确我们中心的情况，我们回顾了20年间我们自己的肾切除指征。
回顾性分析1990年5月至2010年10月在我们中心因泌尿系统和肿瘤原因接受肾切除术患者的病历。记录肾切除指征。记录泌尿系统疾病患者的肾功能。
共进行了357例肾切除术；其中，241例因泌尿系统原因，116例因肿瘤原因。大多数全肾切除术是针对多囊性发育不良肾、反流性肾病、肾盂输尿管连接处梗阻和发育异常进行的。87例患者在肾切除时无功能。其余患者中，17例功能<5%，18例功能为5 - 10%，5例功能为10 - 1十五%，2例患者功能为15 - 20%。
这是小儿外科文献中迄今为止最大的肾切除系列研究。大多数肾切除术是针对相对肾功能<10%的泌尿系统疾病进行的，无法原位有效保留。我们建议，功能>10%的肾脏不应常规切除。
