嚢包腎の手術的療法

Abstract

Sixty nine patients with polycystic kidney were o b serbed for the last nine years from 1953 to 1961, who were 0.004% of all patients in our clinic and were 0.005% of cases with urinary tract lesions. 1) Fifteen patients anderwent multiple sclerosing punctures on the polycystic kidneys. (See table 1) 2) Sex and age (See table 2) 3) Early clinical manifestai o n (See table 3) 4) Method of the operation (See table 4) 5) Comparative studies of pre-and post o perative renal function. (See table 5 and 6) Seven cases improved and the rest progressed worse. In the improved group the a v erage volume of punctured fluid was 80cc for each kidney, ranging from 20 to 305cc. Renal clearance studies showed much improvement of G.F.R. In the aggravated group, the average volume of punctured fluid was 210cc from 60 to 450cc, and in five cases of them 50% dextrose solution was injected in to the cysts of nine kidneys according to Young's method after the puncture. Thism ethod was found unfavorable one from the point of view of renal clearance studies. 6) Changes of symptoms and signs. (See table 7) 7) Survival rate (See table 8) For the polycystic kidneys of the non advanced stage, judging from their pyelogramm and physical examinations, open puncture of the cysts is effective in order to prolong the survival rate and improve the renal function, symptoms and signs, if have been persistent. On the other hand, this method is not indicated for the advanced cases. It is better not to combine intracystic injection of dextrose of high concentration. Puncture only is quite satisfactory.