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目的总结微创开放切口肾切除术治疗小儿多房性肾囊性变(MCDK)的初步经验。方法回顾性分析2008年5月-2010年10月本院连续开展的微创开放切口肾切除术治疗小儿MCDK 15例的临床资料。患儿均为单侧MCDK,均经CT、放射性核素显像和超声检查确诊。对侧功能肾脏未发现异常。男12例,女3例;右侧5例,左侧10例。手术均经腹膜后间隙完成。取腰肋部开放切口,长度1.5～2.0 cm(平均1.7 cm)。手术时年龄3个月～5.6岁(平均2.4岁)。手术时间30～45 min(平均34.6 min)。所有手术术中估计出血量<5 mL。术后静脉予抗生素预防感染2～4 d。结果本组手术均成功。患儿术后住院2～4 d(平均2.8d)。全部患儿术后随访未发现术后并发症。结论微创开放切口肾切除术治疗儿童MCDK可以达到通过开放切口实现微创治疗的目的。本方法手术时间短,美容效果好,术后住院时间短,且安全、有效,容易开展。
Objective To summarize the preliminary experience of minimally invasive open incision nephrectomy for the treatment of multimodal renal cystic degeneration (MCDK) in children. Methods The clinical data of 15 cases of pediatric MCDK treated with minimally invasive open incision nephrectomy in our hospital from May 2008 to October 2010 were retrospectively analyzed. Children were unilateral MCDK, were confirmed by CT, radionuclide imaging and ultrasound. Contralateral kidney function was not found abnormalities. There were 12 males and 3 females, 5 on the right and 10 on the left. Surgery are completed by the retroperitoneal space. Obtained lumbar incision, length 1.5 ~ 2.0 cm (average 1.7 cm). Surgery age 3 months to 5.6 years (mean 2.4 years). The operation time was 30-45 minutes (average 34.6 minutes). All surgical estimates of bleeding <5 mL. Postoperative intravenous antibiotics to prevent infection 2 ~ 4 d. Results The operation was successful in this group. Children hospitalized after 2 ~ 4 days (average 2.8d). All patients with postoperative follow-up found no postoperative complications. Conclusion Minimally invasive open incision nephrectomy for children with MCDK can achieve the purpose of minimally invasive treatment through open incision. The method has short operative time, good cosmetic effect, short postoperative hospital stay, and is safe, effective and easy to carry out.