Salano F, Pecenco G, Scabardi M, Cimaglia M L, Salvatori G, Belloli G
Pediatr Med Chir. 1985 Sep-Oct;7(5):639-42.
Hydronephrosis in infancy and childhood is a frequent urinary malformation and is almost always congenital. In over 80% of the cases it is due to ureteropelvic junction obstruction; much less frequently it is due to anomalous renal vessels, sometimes associated to ureteropelvic junction obstruction. In this paper the Authors analyze their experience in the surgical treatment of this urinary malformation. 234 hydronephrosis out of 222 patients were operated on from January 1972 to June 1985. 61 hydronephrosis were operated on in 55 infants under 1 year. Primary nephrectomy was carried out only in 9 of the 234 hydronephrosis operated on (3.9%) and in 3 of the 61 hydronephrosis operated on in infants less than 1 year old (4.9%). All the 55 infants but one showed a significant radiological improvement after pyeloplasty. 28 infants but one showed a significant radiological improvement after pyeloplasty. 28 infants for a total of 30 hydronephrosis had a glomerular filtration rate determination during sequential scan for individual kidney function assessment. 90% of the kidneys operated on showed a normal or slightly reduced glomerular filtration rate. Recent advances in prenatal echographic diagnosis and relationship between obstructive uropathy, renal development and pulmonary hypoplasia are discussed. The Authors stress out the importance of early diagnosis to improve surgical results.
婴儿期和儿童期肾积水是一种常见的泌尿系统畸形，几乎均为先天性。超过80%的病例是由于肾盂输尿管连接处梗阻；较少见的原因是肾血管异常，有时与肾盂输尿管连接处梗阻相关。本文作者分析了他们在这种泌尿系统畸形手术治疗方面的经验。1972年1月至1985年6月期间，对222例患者中的234例肾积水进行了手术。对55例1岁以下婴儿的61例肾积水进行了手术。在接受手术的234例肾积水中，仅9例（3.9%）进行了一期肾切除术，在1岁以下婴儿接受手术的61例肾积水中，3例（4.9%）进行了一期肾切除术。除1例婴儿外，所有55例婴儿在肾盂成形术后均显示出明显的影像学改善。28例婴儿（共30例肾积水）在序贯扫描期间进行了肾小球滤过率测定，以评估单个肾功能。90%接受手术的肾脏显示肾小球滤过率正常或略有降低。本文还讨论了产前超声诊断的最新进展以及梗阻性尿路病、肾脏发育和肺发育不全之间的关系。作者强调早期诊断对改善手术效果的重要性。
