儿童肾切除术:单一中心经验

C. Emeka, Eze Chikaodili, Anijunsi Livinus Patrick
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摘要

背景:手术切除肾脏,即肾切除术,并不是一个小的外科手术。这是一项重大的努力。肾切除术的适应症从良性到恶性不等。材料和方法:这是一项回顾性研究,研究对象是2016年1月至2020年12月期间在尼日利亚埃努古(Enugu)一家教学医院儿科外科接受肾切除术的15岁及以下儿童。提取的信息包括患者就诊时的年龄、性别、主要症状和病理(指征)、就诊前症状的持续时间、就诊至肾切除术的时间间隔、手术方式、治疗并发症、住院时间和治疗结果。结果:在研究期间进行了18例小儿肾切除术。男性14例(77.8%),女性4例(22.2%)。患者平均年龄6岁,年龄范围3 ~ 9岁。肾母细胞瘤是肾切除术最常见的指征(病理)。左侧肾切除术多于右侧肾切除术。所有患者均行单纯肾切除术。然而,患有肾母细胞瘤的儿童接受肾输尿管切除术。手术部位感染是最常见的术后并发症。约四分之一的患者因肿瘤转移而死亡。结论:肾切除术是治疗肾肿瘤或无功能肾的最佳方法。恶性肾肿瘤(肾母细胞瘤)是本研究中最常见的肾切除术指征。
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Nephrectomy in Children: A Single Center Experience
Background: The surgical removal of the kidney, nephrectomy, is not a minor surgical procedure. It is a major endeavor. Indications for nephrectomy range from benign to malignant pathological conditions. Materials and Methods: This was a retrospective study of children aged 15 years and below who had nephrectomy between January 2016 and December 2020 at the pediatric surgery unit of a teaching hospital in Enugu, Nigeria. The information extracted included the age of the patient at presentation, gender, and predominant presenting symptom and the pathology (indication), duration of symptoms before presentation to the hospital, time interval between presentation and nephrectomy, operative procedure performed complications of treatment, duration of hospital stay and outcome of treatment. Results: Eighteen (18) pediatric nephrectomies were performed during the study period. There were 14 (77.8%) males and 4 (22.2%) females. The mean age of the patients was 6 years with a range of 3 years to 9 years. Nephroblastoma was the most common indication (pathology) for nephrectomy. Nephrectomies were performed more on the left side than on the right. Simple nephrectomy was performed in all the patients. However, children with nephroblastoma had nephroureterectomy. Surgical site infection was the most common post-operative complication. About one-quarter of the patients expired due to tumor metastasis. Conclusion: Nephrectomy is the optimal procedure for neoplasm of the kidney or non-functional kidney. Malignant kidney tumour (nephroblastoma) was the most common indication for nephrectomy in the present study.
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