Ilić I, Knego Z, Kacić P
Acta Chir Iugosl. 1977;24(1 Suppl):249-58.
Incidence of renal hydatid cyst is rare and its diagnosis should be made with the utmost care and after subjecting the patient to intensive investigations to exclude other pathologies. Because of the rarity of the disease and because of the clinical similarity with other surgical lesions affecting the kidney, mainly renal tumours and simple renal cysts, the authors are encouraged to record thirty-nine cases of renal hydatid cysts. The value of investigations as aids in the diagnosis has been discussed. The direct consequence of uncertain diagnosis is the risk of performing unwarranted ablative surgery, whereas conservative treatment is currently advocated by the majority of investigators. We followed the policy of saving as much renal tissue in each case, and we obtained results that encourage us to believe that nephrectomy for renal hydatidosis can be avoided in a great many cases with complete therapeutic success. With the exception of cystectomy and marsupialisation--which is recommended as a lifesaving procedure, the method of our choice consisted of a partial pericystectomy, i.e. resection of the pericystium exteriorized until it was flush with the renal parenchyma.
肾包虫囊肿的发病率很低,其诊断应极其谨慎,且需对患者进行深入检查以排除其他病变后才能做出。由于该疾病罕见,且在临床上与影响肾脏的其他外科病变(主要是肾肿瘤和单纯性肾囊肿)相似,作者们特此记录了39例肾包虫囊肿病例。文中讨论了各项检查在诊断中的辅助价值。诊断不明确的直接后果是进行不必要的切除手术的风险,而目前大多数研究者主张采用保守治疗。我们遵循在每个病例中尽可能保留肾组织的原则,并且我们所取得的结果使我们相信,在许多病例中可以避免因肾包虫病而进行肾切除术,且能取得完全的治疗成功。除了囊肿切除术和袋形缝合术(推荐作为挽救生命的手术方法)外,我们选择的方法是部分囊肿外膜切除术,即切除突出的囊肿外膜直至与肾实质齐平。