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[根据恶性风险的肾囊肿手术治疗特点]

[Features of surgical treatment of renal cysts depending on the risk of malignancy].

作者信息

Simonov P A, Firsov M A, Laletin D I, Alekseeva E A, Junker A I

机构信息

GBUZ Regional Clinical Hospital, Krasnoyarsk, Russia.

Department of Urology, Andrology and Sexology, FGBOU VO Krasnoyarsk State Medical University. Prof. V.F. Voino-Yasenetsky Ministry of Health of Russia Krasnoyarsk, Russia.

出版信息

Urologiia. 2022 Sep(4):23-26.

Abstract

BACKGROUND

According to national and foreign publications, renal cyst is one of the most common urological diseases with a prevalence up to 20-50%.

AIM

To determine the results of surgical treatment of patients with renal cysts, depending on the risk of malignancy.

MATERIALS AND METHODS

The analysis of 124 patients with symptomatic renal cysts who were treated in the Department of Urology of Regional Clinical Hospital was carried out. All patients underwent a comprehensive clinical and instrumental evaluation, including contrast-enhanced CT scan of the kidneys. To assess the risk of harboring malignant tumor, the classification of renal cysts of Bosniak (2019) was used.

RESULTS

The average age of patients was 56.6+/-12 years. According to CT, Bosniak I, II, IIF and III cysts were diagnosed in 96 (77.4%), 11 (8.9%), 11 (8.9%) and 6 (4.8%) patients, respectively. The morphologic study revealed renal cell cancer in 8 patients (6.4%), four of whom had Bosniak III cysts and other four had Bosniak IIF cysts.

DISCUSSION

The prediction of the harboring of malignancy is a fundamental criterion for selection of patients with renal cysts for surgical treatment.

CONCLUSION

Surgical treatment of symptomatic renal cysts is a justified treatment method, and in patients with Bosniak class II or higher cysts, it is necessary to exclude the malignant lesion. Based on our data, category IIF and III cysts have a high risk of harboring malignant cells, which is 36.4% and 66.7%, respectively. In our opinion, laparoscopic partial nephrectomy is the most rational treatment method in these categories.

摘要

背景

根据国内外文献,肾囊肿是最常见的泌尿系统疾病之一,患病率高达20%-50%。

目的

根据恶性风险确定肾囊肿患者的手术治疗结果。

材料与方法

对区域临床医院泌尿外科治疗的124例有症状肾囊肿患者进行分析。所有患者均接受了全面的临床和仪器评估,包括肾脏增强CT扫描。为评估存在恶性肿瘤的风险,采用了波斯尼亚克(2019年)肾囊肿分类法。

结果

患者的平均年龄为56.6±12岁。根据CT检查,分别在96例(77.4%)、11例(8.9%)、11例(8.9%)和6例(4.8%)患者中诊断出波斯尼亚克I类、II类、IIF类和III类囊肿。形态学研究发现8例患者(6.4%)患有肾细胞癌,其中4例有波斯尼亚克III类囊肿,另外4例有波斯尼亚克IIF类囊肿。

讨论

恶性肿瘤存在的预测是选择肾囊肿患者进行手术治疗的基本标准。

结论

有症状肾囊肿的手术治疗是一种合理的治疗方法,对于波斯尼亚克II类或更高类囊肿的患者,有必要排除恶性病变。根据我们的数据,IIF类和III类囊肿存在恶性细胞的风险较高,分别为36.4%和66.7%。我们认为,腹腔镜下部分肾切除术是这些类型中最合理的治疗方法。

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