Clinical Analysis Of Surgical Treatment Of Duplex Kidney In Children

Objective: Through Analyzing the information of children with duplex kidney such as basic information,imaging data,operation methods,postoperative efficacy,further guide the surgery of duplex kidney,then improve the prognosis effect.Methods: Firstly we retrospect 98 medical records of the children with duplex kidney,which underwent surgery in our hospital from March 2008 to April 2017.Secondly,we evaluate the postoperative prognosis,explore the relationship between age,surgical methods,preoperative reflux,preoperative infection(UTI),ureterocele,ectopic ureteral orifice,preoperative renal function and postoperative prognosis.Finally we analysis the risk factors and the the best treatment.Results: Follow up ranged from 9 to 118 months(mean: 56).There are 25 boys and 73 girls(M:F=1:3),these children are from 1 month to 156 months(average age,37±36 months).From the position,there are 34 cases on the left side,37 cases on the right side and 27 cases on both sides(S:D=1:2.6).The proportion of complete duplex kidney is 95.9%(94 cases),and incomplete duplex kidney is 4.1%(4 cases).The main reasons for first outpatient visit are urinary tract infection(36.73%)and prenatal examination(23.47%).And the main surgical indications are recurrent urinary tract infections(42.86%)and urine dripping(21.43%).Surgical methods are associated with prognosis,and the radical surgery is better than palliative surgery(p=0.006).The interaction effect of surgical methods and differential renal function of upper renal are associated with prognosis,and when the differential renal function of the upper kidney is poor(<10%),the best way is to perform radical surgery,however it does not matter whether or not preserve the upper kidney.Conclusion: The surgical approach is related to the prognosis of patients,and the prognosis of radical surgery is better than that of palliative surgery.In patients with poor renal function of the upper kidney(<10%),the radical surgery is better than palliative surgery in pratical.In clinical,we should choose individualized treatment plans according to the different conditions of children,to obtain good curative effect and improve the quality of life of children.