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婴儿和儿童重复肾融合畸形非功能部分腹腔镜单部位肾部分切除术的长期随访。

Long-Term Follow-Up of Laparoendoscopic Single-Site Partial Nephrectomy for Nonfunctioning Moieties of Renal Duplication and Fusion Anomalies in Infants and Children.

机构信息

Division of Pediatric Urology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

出版信息

J Endourol. 2020 Feb;34(2):134-138. doi: 10.1089/end.2019.0393.

Abstract

To report on long-term follow-up and outcomes of infants and small children who have undergone laparoendoscopic single-site (LESS) partial nephrectomy to manage upper urinary tract duplication and fusion anomalies. A retrospective review was performed evaluating outcomes of pediatric patients who underwent LESS partial nephrectomy for upper urinary tract duplication and fusion anomalies from January 2012 to July 2015, by a single surgeon at a tertiary pediatric referral center. Demographic and perioperative data were reviewed as well as follow-up imaging. Descriptive statistics were used for analysis. A total of 18 patients were identified. Additional access was used for two patients to complete the procedure. Median follow-up was 39 months. No short-term complications were encountered. Three patients were noted to have abnormal postoperative ultrasounds: two perinephric fluid collections and one atrophy of the remaining ipsilateral moiety. One fluid collection resolved completely, and the other decreased in size. Complete atrophy of the ipsilateral moiety occurred. No secondary procedures were required. LESS partial nephrectomy is safe for renal duplication and fusion anomalies with good long-term outcomes. Although it can be safely performed, it is a technically demanding procedure and has been discontinued in favor of robotic partial nephrectomy.

摘要

报告接受腹腔镜单部位(LESS)部分肾切除术治疗上尿路重复和融合畸形的婴儿和幼儿的长期随访结果和结局。对 2012 年 1 月至 2015 年 7 月期间,一位小儿外科医生在一家三级儿科转诊中心接受 LESS 部分肾切除术治疗上尿路重复和融合畸形的小儿患者的结局进行了回顾性评估。对患者的人口统计学和围手术期数据以及随访影像学进行了回顾。采用描述性统计学进行分析。共确定了 18 例患者。另外两名患者需要额外的辅助操作来完成手术。中位随访时间为 39 个月。无短期并发症发生。3 例患者术后超声检查异常:2 例肾周积液,1 例同侧剩余部分萎缩。1 例积液完全吸收,另 1 例积液减少。同侧剩余部分完全萎缩。无需进行二次手术。LESS 部分肾切除术治疗肾重复和融合畸形是安全的,具有良好的长期结局。尽管它可以安全地进行,但这是一个技术要求很高的手术,已经被机器人部分肾切除术取代。

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