Clinical Analysis Of Different Surgical Methods In Children With Duplicated Kidney

Objective:To explore the surgical treatment of children with repetitive kidney.Methods:A total of 70 children with duplicate kidney who needed surgical intervention admitted to our hospital from February 2017 to August 2022 were retrospectively analyzed,and were statistically divided into group A and Group B according to different surgical methods.A total of 42 children in group A underwent laparoscopic repeat nephrectomy and ureterectomy.A total of 28 children in group B received repeated kidney tissue preservation surgery,17 of whom received fenestration of aerocystial cyst.Nine patients underwent laparoscopic uretero-ureteral end-to-side anastomosis.Two of the children underwent aerocystoureteral bladder replantation.The clinical symptoms,recovery of repetitive kidney segment,operation time,postoperative hospital stay,operation cost,secondary operation and postoperative complications of the two groups of children were analyzed and compared,and the treatment plan selection strategy of repetitive kidney surgery was summarized.Results:1.There were no significant differences in age,gender,side and preoperative clinical symptoms between the two groups(P>0.05).2.The 28 children in group B underwent repeated kidney tissue preservation operation,and the ureteral morphology of the repeated kidney was recovered satisfactorily during postoperative follow-up,with statistical significance compared with that before surgery(P<0.05).3.Overall,the postoperative complications(14.3%vs.4.8%)and reoperation rate(10.7%vs.0%)of group B were higher than those of group A,but the difference was not statistically significant(P>0.05).4.There was no significant difference in postoperative complications(17.6%vs.9.1%)and reoperation rate(17.6%vs.0%)in children with ureteral cyst with the preserved repeat kidney group compared with the non-preserved repeat kidney group(P>0.05).The operation time(43.53±1.91min vs.98.00±6.34min)was shorter(P<0.05)and the hospitalization cost(30199.03±1532.94 yuan vs.39392.33±1409.55 yuan)was lower(P<0.05).5.No secondary operation was performed in the patients with ectopic ureteral opening.There was no significant difference in postoperative complications(10%vs 0%)between the group with and without duplicate kidney retention(P>0.05),but the operative time(137.00±9.92min vs.107.45±9.59min)was longer(P<0.05).Conclusions:1.It is one of the reliable treatment options for duplicate kidney because the shape of duplicate kidney recovers satisfactorily after the operation of preserving duplicate kidney tissue and does not significantly increase the incidence of postoperative complications and the risk of second operation.2.The surgical plan to retain duplicate kidney should be selected according to the combination of urinary system malformations.Fenestration of aerocystoureteral cyst is suitable for children with ureteral cyst.Laparoscopic ureteral anastomosis is suitable for children with ectopic ureteral opening.Aircystoureteral replantation is recommended for children with vesicoureteral reflux.