肾错构瘤的诊断与治疗(附40例)

Diagnosis and treatment of renal hamartoma(40 cases)

目的:探讨肾错构瘤(RAML)的诊断以及选择合适的治疗方法。方法:回顾性分析与总结2014年1月至2016年9月我院收治的40例肾错构瘤患者的临床资料、影像学检查、治疗方法、病理及随访结果。结果:40例中28例影像学检查诊断肾错构瘤,12例怀疑肾癌。本组40例患者根据病情,6例行对症保守治疗,恢复良好后出院,门诊定期复查随访1~22个月,其中一例随访至9个月后出现破裂出血,再次入院行保守治疗。34例行手术治疗,术后病理证实为错构瘤。34例手术患者,术后均恢复良好,随访2~32个月,未见复发恶变及转移。结论:B超和CT是行之有效的诊断肾错构瘤的影像检查。对于应行手术治疗的肾错构瘤,尽量保留肾单位,肿瘤直径大或伴有破裂出血的患者应行开放肾部分切除术;肿瘤直径较小者,腹腔镜肾部分切除术(LPN)是有效的外科治疗方式。

Objective: To explore the diagnosis and select the appropriate treatment of renal hamartoma. Methods:We retrospectively analyzed and summarized the clinical data,imaging,treatment,pathology and follow-up results of 40 patients with renal hamartoma treated in our hospital from January 2014 to September 2016. Results: In 40 cases,there were 28 cases of imaging were diagnosed as renal hamartoma,the other 12 cases were suspected for kidney cancer. In this group of 40 patients,according to their condition,there were 6 cases underwent conservative treatment and recovery well afther hospital discharge,who were reviewed and followed up for 1 to 22 months. One case followed up to 9 months after the rupture of bleeding admitted to hospital and underwent conservative treatment again. There were 34 cases underwent surgical treatment and were confirmed renal hamartoma by pathology afther operation. The 34 patients underwent surgery recovered well,who were followed up for 2 to 32 months,with no recurrence,malignant transformation and metastasis. Conclusion: Ultrasound and CT is an effective imaging examination in the diagnosis of renal hamartoma. For renal hamartoma,which should be surgical treatment,nephron-sparing surgery( NSS) is ecessary,if patients’ tumor diameter is big or associated with rupture of bleeding,open partial nephrectomy surgery should be considered. Laparoscopic partail nephrectomy( LPN) is an effective surgical treatment for tumor diameter is small.