XANTHOGRANULOMATOUS PYELONEPHRITIS - CLINICAL FINDINGS AND SURGICAL CONSIDERATIONS
XANTHOGRANULOMATOUS PYELONEPHRITIS - CLINICAL FINDINGS AND SURGICAL CONSIDERATIONS
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DOI：
10.1016/0090-4295(94)90069-8
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发表时间：
1994-03-01
期刊：
影响因子：
2.1
通讯作者：
SKINNER, E
中科院分区：
文献类型：
--
作者：
EASTHAM, J;AHLERING, T;SKINNER, E
客观的。黄色肉芽肿性肾盂肾炎（XGP）是一种罕见但特征明确的肾脏炎症过程。然而，很少有报告将术前放射学特征与手术探查的结果相关联。我们报告 XGP 手术管理的经验，重点是在术前评估中使用计算机断层扫描 (CT)。方法。我们回顾性审查了 27 例病理诊断为 XGP 的患者的所有医疗记录，包括影像学材料。特别是，分析了术前 CT 特征，看看它们是否与手术结果相关。结果。 27 名患者中的 23 名进行了 CT 扫描。在这 23 名患者中，有 20 名（87%）根据 CT 检查结果被诊断为 XGP。 Cr 准确地定义了肾周炎症反应的程度，确定了 8 例肌肉延伸的患者、3 例脾脏受累的患者、1 例延伸到结肠的患者、5 例大血管包绕的患者。 Cr 在任何情况下都不会低估邻近组织的参与。结论。尽管 XGP 是一种罕见疾病，但仔细的术前评估可以提示其诊断。 Cr 特别有价值，因为它不仅显示了特征性的肾脏发现，而且还显示了炎症的程度和邻近组织的程度。这将有助于手术计划选择一种能够提供足够暴露并促进患者护理的方法。
Objective. Xanthogranulomatous pyelonephritis (XGP) is an uncommon but well-characterized inflammatory process of the kidney. Few reports, however, have correlated preoperative radiographic features with findings at surgical exploration. We report our experience in the surgical management of XGP with emphasis on the use of computed tomography (CT) in the preoperative evaluation.Methods. We retrospectively reviewed all medical records including radiographic materials of 27 patients with a pathologic diagnosis of XGP. In particular, preoperative CT features were analyzed to see if they correlated with surgical findings.Results. A CT scan was performed in 23 of the 27 patients. Of these 23 patients 20 (87%) were diagnosed with XGP based on the CT findings. Cr accurately defined the extent of the perinephric inflammatory reaction, identifying 8 patients with muscular extension, 3 with splenic involvement, 1 with extension into the colon, and 5 with encasement of the great vessels. In no case did Cr underestimate the involvement of adjacent tissues.Conclusions. Although XGP is a rare disease, a careful preoperative evaluation can suggest its diagnosis. Cr is particularly valuable in that it not only demonstrates characteristic renal findings, but also shows the extent of inflammation and extent into adjacent tissues. This will aid in surgical planning in choosing an approach that will provide adequate exposure and facilitate patient care.