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对多囊性发育不良肾患儿行微创开放性肾切除术。

Minimally invasive open nephrectomy on children with multicystic dysplastic kidney.

作者信息

Feng Dongchuan, Zhu Xiaoyu, Sun Fang, Ma Tongsheng, Li Yuan, Chen Shujing

机构信息

Department of Urology, Xuzhou Children's Hospital, Xuzhou, Jiangsu 221002, P.R. China.

出版信息

Exp Ther Med. 2016 Dec;12(6):3575-3578. doi: 10.3892/etm.2016.3816. Epub 2016 Oct 18.

DOI:10.3892/etm.2016.3816
PMID:28101154
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5228073/
Abstract

The aim of the study was to summarize the preliminary experience of minimally invasive open nephrectomy operation on children with multicystic dysplastic kidney (MCDK). A retrospective review was performed on the clinical materials of the 15 children that had accepted consecutive minimally invasive open nephrectomies during the previous 2 years. The enrolled children were diagnosed with unilateral MCDK under computed tomography, emission computerized tomography and ultrasound and no anomaly in the contralateral functioning kidney was found. Of the 15 children, 12 were boys and 3 were girls, with 5 cases on the right and 10 cases on the left. Operations were completed at the retroperitoneal space in order to open an incision on the waists and ribs of the children, the length of which ranged from 1.5 to 2.0 cm (average 1.7 cm). The age of the children at operation ranged from 3 months to 5.6 years old, with an average of 2.4 years old. Surgery lasted for 30-50 min, with an average of 34.6 min. The estimated blood loss of each child was <5 ml. After operation, prophylactic intravenous antibiotics were administered for 2-4 days to prevent infection. All of the operations proved very successful. Following surgery the children were hospitalized for 2-4 days for observation, with an average of 2.8 days. No complications occurred during the follow-up period. In conclusion, minimally invasive open nephrectomy is effective for children with MCDK. The procedure is superior with regard to operative time, cosmesis, and length of stay. It is a safe and effective treatment choice for patietns with MCDK and can be easily performed on children.

摘要

本研究的目的是总结微创开放性肾切除术治疗儿童多囊性发育不良肾(MCDK)的初步经验。对过去2年中连续接受微创开放性肾切除术的15例儿童的临床资料进行回顾性分析。入选儿童经计算机断层扫描、发射计算机断层扫描和超声诊断为单侧MCDK,对侧功能肾无异常。15例儿童中,男12例,女3例,右侧5例,左侧10例。手术在腹膜后间隙进行,以便在儿童腰部和肋骨处做切口,切口长度为1.5至2.0厘米(平均1.7厘米)。手术时儿童年龄为3个月至5.6岁,平均2.4岁。手术持续30 - 50分钟,平均34.6分钟。每个儿童估计失血量<5毫升。术后预防性静脉应用抗生素2 - 4天以预防感染。所有手术均非常成功。术后儿童住院观察2 - 4天,平均2.8天。随访期间无并发症发生。总之,微创开放性肾切除术治疗儿童MCDK有效。该手术在手术时间、美容效果和住院时间方面更具优势。对于MCDK患儿来说,它是一种安全有效的治疗选择,且易于在儿童身上实施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb85/5228073/32d799a31ee8/etm-12-06-3575-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb85/5228073/6ac50c7bb424/etm-12-06-3575-g00.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb85/5228073/73136610acc2/etm-12-06-3575-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb85/5228073/9856cd1e6a7a/etm-12-06-3575-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb85/5228073/32d799a31ee8/etm-12-06-3575-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb85/5228073/6ac50c7bb424/etm-12-06-3575-g00.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb85/5228073/73136610acc2/etm-12-06-3575-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb85/5228073/9856cd1e6a7a/etm-12-06-3575-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb85/5228073/32d799a31ee8/etm-12-06-3575-g03.jpg

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本文引用的文献

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Transcriptional dysregulation in the ureteric bud causes multicystic dysplastic kidney by branching morphogenesis defect.输尿管芽中的转录失调通过分支形态发生缺陷导致多囊性发育不良肾。
J Urol. 2015 May;193(5 Suppl):1784-90. doi: 10.1016/j.juro.2014.08.122. Epub 2014 Oct 6.
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Multicystic dysplastic kidney: a retrospective study.
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Indian Pediatr. 2014 Aug;51(8):641-3. doi: 10.1007/s13312-014-0467-z.
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J Pediatr Urol. 2014 Aug;10(4):655-61. doi: 10.1016/j.jpurol.2014.06.001. Epub 2014 Jul 4.
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Ultrasound diagnosis of multicystic dysplastic kidney: is a confirmatory nuclear medicine scan necessary?多囊性发育不良肾的超声诊断:是否需要进行确诊性核医学扫描?
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