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[双侧肾脏手术治疗结果]

[Results of operative therapy of double kidney].

作者信息

Ringert R H, Koskinas S, Hartung R

出版信息

Urologe A. 1985 Mar;24(2):87-93.

PMID:4039496
Abstract

107 patients were submitted to operative treatment of a duplex kidney from 1968 to 1980. In 62 kidneys of children heminephrectomy was performed and in 26 parenchymapreserving operations like ureterocystoneostomies (n = 17) and pyelopyelostomies (n = 9) were done. Fever and urinary tract infection was seen more often in patients submitted to partial ureterectomy than after total ureterectomy. Long time follow-up (medium 8.8 years) was available in 33% of the children. Two non-functioning renal units after heminephrectomy and one recurrent vesicoureteral reflux were documented. Renal length was determined by planimetry. While values within the +/- 2SD range were seen after antireflux surgery and after pyelopyelostomies growth of the kidneys after heminephrectomy seemed to be hampered. Although renal hypoplasia and dysplasia is seen in a lot of duplex kidneys, heminephrectomy should not be done routinely. Preoperative planimetry of the kidney gives information about the amount of parenchyma most probably lost by heminephrectomy. In addition malfunction of the contralateral "good" kidney should be suspected, if compensatory hypertrophy of this kidney does not develop in spite of a grossly scarred contralateral kidney.

摘要

1968年至1980年期间,107例患者接受了重复肾的手术治疗。在62例儿童患者的肾脏中进行了半肾切除术,26例进行了保留实质的手术,如输尿管膀胱吻合术(17例)和肾盂肾盂吻合术(9例)。接受部分输尿管切除术的患者比接受全输尿管切除术的患者更常出现发热和尿路感染。33%的儿童有长期随访(平均8.8年)。记录了2例半肾切除术后无功能肾单位和1例复发性膀胱输尿管反流。通过平面测量法测定肾脏长度。抗反流手术和肾盂肾盂吻合术后肾脏长度值在±2标准差范围内,而半肾切除术后肾脏的生长似乎受到阻碍。虽然在许多重复肾中可见肾发育不全和发育异常,但不应常规进行半肾切除术。术前对肾脏进行平面测量可提供有关半肾切除术最可能损失的实质数量的信息。此外,如果对侧“好”肾尽管对侧肾有明显瘢痕但仍未出现代偿性肥大,则应怀疑对侧肾有功能障碍。

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