Kaneda T, Konda R, Orikasa S, Sakai K, Ota S, Abe Y, Hatakeyama T, Ikeda S, Kuji S
Department of Urology, Tohoku University School of Medicine.
Nihon Hinyokika Gakkai Zasshi. 1993 Feb;84(2):297-302. doi: 10.5980/jpnjurol1989.84.297.
The effects of partial or total removal of the kidney with ectopic ureter on the contralateral kidney were evaluated using DMSA renal uptake rate on 8 patients. After partial nephrectomy on 6 cases, the affected residual kidneys showed significant decrease in DMSA renal uptake rate in 2 cases in which the extirpated kidneys had normal renal tissue in part but did not show significant change in DMSA uptake rate in 4 cases in which the extirpated kidneys were dominated mainly with dysplasia. Post-operative increase in DMSA uptake rate of the contralateral kidneys were significant in 3 of 4 patients who had the operation before they became 2 years old. In 2 of these 3 cases, pre-operative scintigram showed extremely low rate of DMSA renal uptake. Four cases aged 2 years old and over did not show post-operative increase in the uptake rate. As we have previously reported on the cases with hydronephrosis, these results suggest that 1) existence of obstruction caused by ectopic ureter inhibit the development of the contralateral kidney and 2) the growth of the kidney can resume the release of that obstruction, if the release is made while the kidneys are still in developing stage.
利用二巯基丁二酸(DMSA)肾摄取率,对8例异位输尿管伴肾部分或全部切除术后对侧肾脏的影响进行了评估。6例行部分肾切除术后,切除的肾脏部分有正常肾组织的2例,患侧残余肾脏的DMSA肾摄取率显著降低;切除的肾脏主要为发育异常的4例,患侧残余肾脏的DMSA摄取率无显著变化。4例2岁前接受手术的患者中,有3例对侧肾脏术后DMSA摄取率显著增加。在这3例中的2例,术前闪烁扫描显示DMSA肾摄取率极低。4例2岁及以上患者术后摄取率未增加。正如我们之前对肾积水病例的报道,这些结果表明:1)异位输尿管引起的梗阻会抑制对侧肾脏的发育;2)如果在肾脏仍处于发育阶段时解除梗阻,肾脏的生长可以恢复。