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超声引导下穿刺抽吸及硬化治疗儿童单纯性肾囊肿:与腹腔镜去顶术的对比研究及治疗方法的优化

Ultrasonography-guided aspiration and sclerotherapy for simple renal cysts in children: a comparative study with laparoscopic deroofing and optimization of therapeutic approaches.

作者信息

He Jiali, Yu Xianhai, Zhang Li, Yang Chunjiang, Guo Qitong, Li Ping, Wu Shengde, Hua Yi, Liu Xing, He Dawei, Lin Tao, Zhang Deying, Wei Guanghui

机构信息

National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Structural Birth Defect and Reconstruction, Department of Urology Children's Hospital of Chongqing Medical University, 136 Zhongshan Road, Chongqing, 400014, China.

National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Department of Ultrasound Children's Hospital of Chongqing Medical University, Chongqing, 400014, China.

出版信息

Pediatr Surg Int. 2025 Jan 6;41(1):58. doi: 10.1007/s00383-024-05960-1.

Abstract

OBJECTIVE

To compare the clinical outcomes of ultrasonography-guided aspiration and sclerotherapy and laparoscopic deroofing for the treatment of simple renal cysts in children, providing evidence for clinical decision-making in the management of pediatric renal cysts.

METHODS

A total of 49 patients with simple renal cysts were divided into two groups based on the treatment method: 29 patients (group 1) underwent laparoscopic deroofing, 20 patients (group 2) underwent ultrasonography-guided aspiration and sclerotherapy. The clinical efficacy differences between the two groups were compared. During the study period, optimizations were made to the aspiration and sclerotherapy procedure in terms of sclerosant injection volume, sclerosing time, frequency, and intervals.

RESULTS

The complete disappearance rate of cysts in group 2(95.0%) was significantly higher than that in group 1 (33.3%) (P < 0.001). The recurrence rate of cysts in group 2 was 0%, significantly lower than that in group 1 (33.3%) (P = 0.014). The group 2 had shorter hospital duration, indwelling catheterization duration, indwelling drainage duration, intraoperative blood loss, and operative time compared to the group 1 (P < 0.001). No severe complications such as intra-abdominal organ injury occurred in either group. However, in the group 2, 6 cases experienced transient low back pain and/or "alcoholic reaction", which resolved spontaneously.

CONCLUSION

Compared to laparoscopic deroofing, aspiration and sclerotherapy for simple renal cysts in children demonstrates a higher complete disappearance rate. It is an economical, minimally invasive, and effective treatment option. The modified aspiration and sclerotherapy in this study showed good clinical outcomes and is worthy of further promotion.

摘要

目的

比较超声引导下穿刺硬化治疗与腹腔镜去顶术治疗小儿单纯性肾囊肿的临床疗效,为小儿肾囊肿治疗的临床决策提供依据。

方法

将49例单纯性肾囊肿患儿按治疗方法分为两组:29例(1组)行腹腔镜去顶术,20例(2组)行超声引导下穿刺硬化治疗。比较两组临床疗效差异。研究期间,在硬化剂注射量、硬化时间、频率及间隔方面对穿刺硬化治疗操作进行优化。

结果

2组囊肿完全消失率(95.0%)显著高于1组(33.3%)(P<0.001)。2组囊肿复发率为0%,显著低于1组(33.3%)(P = 0.014)。与1组相比,2组住院时间、留置导尿时间、留置引流时间、术中出血量及手术时间均较短(P<0.001)。两组均未发生腹腔脏器损伤等严重并发症。然而,2组有6例出现短暂性腰痛和/或“酒精反应”,均自行缓解。

结论

与腹腔镜去顶术相比,小儿单纯性肾囊肿穿刺硬化治疗囊肿完全消失率更高。是一种经济、微创且有效的治疗选择。本研究改良的穿刺硬化治疗临床效果良好,值得进一步推广。

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