First Experience of the Uretero-Ureteroanastomosis (Ureteropyeloanastomosis) in Children With Complete Ureteral Duplication

Kagantsov, Ilya M.; Сизонов, В. В.; Дубров, В. И.; Bondarenko, S.; Акрамов, Н. Р.; Шмыров, О С; Kuzovleva, G.I.; Суров, Р. В.; Логваль, А. А.

doi:10.21886/2308-6424-2017-5-4-29-38

Cited by 6 publications

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“…В арсенале хирургических методик имеются как традиционные открытые оперативные вмешательства (нефрэктомия (НЭ), геминефрэктомия (ГНЭ)), так и ставшая в последнее время распространённой методика наложения ипсилатерального уретероуретероанастомоза (УУА). В последние годы НЭ, ГНЭ и УУА всё чаще выполняются с использованием лапароскопического доступа (ЛД), что позволяет прецизионно и малотравматично удалить патологически изменённый мочеточник на всём протяжении [1,3,4]. При каждом из этих вмешательств, несмотря на технику и мастерство хирурга, не всегда удаётся полностью иссечь дистальный отдел мочеточника.…”

Section: оригинальные статьиunclassified

Ureteral stump syndrome after ureteroureteroanastomosis, heminephrectomy and nephrectomy in children

et al. 2020

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Introduction. Nephrectomy (NE), heminephrectomy (HNE) and the formation of ipsilateral ureteroureteroanastomosis (UUA) do not exclude the possibility of preserving the distal ureter. The remaining ureteral stump can cause the formation of ureteral stump syndrome (USS) in the form of recurrent urinary tract infection (UTI), hematuria, pain syndrome, and stump empyema in some cases.Purpose of the study. To assess the incidence and treatment approach of USS in children after NE, HNE and UUA performed using open and laparoscopic access in different Russian clinics.Material and methods. The study is based on the results of treatment of 778 patients from 9 clinics in the Russian Federation and the Republic of Belarus in the period from 1998 to 2020. Patients underwent NE, HNE and UUA by open or laparoscopic access. The ureter was not removed completely, its stump was left. Open access was used in 313 (40.2%) children, laparoscopic in 465 (59.8%) cases. USS was detected in 27 (3.5%) patients. The ureteral stump was removed in 26 (96.3%) children. Open removal of the ureteral stump was performed in 11 (42.3%) patients, through laparoscopic access in 13 (50.0%) and vesicoscopically in 2 (7.7%) children.Results. There were 12 boys (44.4%) and 15 girls (55.6%) among the patients with USS. USS was detected on the right in 13 (48.1%) children, on the left - in 14 (51.9%). The median age of the patients was 25 [12; 42] months at the time of USS detection. Ureteral stump was sutured and ligated in 15 (55.6%) children during the primary operation, the stump was left open after excision in 4 (14.8%) children, it was not indicated how the stump was processed in 8 (29.6%) patients. Reflux to the stump was detected in 13 (48.1%) patients, USS against the background of obstruction was detected in 14 (51.9%) children. It was determined that the frequency of SCM is lower (9 (1.9%)) with the use of laparoscopic access than with open (18 (5.8%)) operations (p < 0.004). Clinical manifestations occurred in 85% of patients with USS within a year after surgery.Conclusion. USS is a rare complication (3.5% of cases) in patients who have undergone NE, HNE and UUA with the distal ureteric stump preserving. Performing these operations by laparoscopic access allows carrying out total ureterectomy and significantly reduces the likelihood of USS development.

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Ureteral stump syndrome after ureteroureteroanastomosis, heminephrectomy and nephrectomy in children

et al. 2020

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Proximal ureterouretheroanastomosis in the treatment of kidney double in children

Kozlov,

Bregel,

Poloyan

et al. 2023

Endosk. khir.

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A rare variant of obstruction of the pyeloureteral segment of the lower half in a child with doubling of the upper urinary tract: Сase report

Сизонов

Shidaev

Kagantsov³

et al. 2022

Russian Journal of Pediatric Surgery, Anesthesia and Intensive

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Presentation of a rare clinical case of hydronephrosis of the lower half of the kidney due to vasoureteral conflict against the background of the complete doubling of the upper urinary tract. The rarity of this anomaly is demonstrated by only a single mention of a similar case in an adult patient in the literature. The patient, three years old, had dilatation of the upper urinary tract that was detected antenatally. According to the postnatal ultrasound results at three months, the anterior-posterior size of the pelvis of the lower half of the left kidney was 13 mm, and the parenchyma of the left kidney was 11 mm. The child was followed up on an outpatient basis. There were no laboratory or clinical manifestations of urinary tract infection. Ultrasound monitoring revealed progression of dilatation of the pelvis of the lower half max up to 40 mm and thinning of the kidney parenchyma in the projection of the lower pole up to 7 mm, in connection with which the child successfully underwent antevasal ureteropyeloanastomosis of the lower half of a completely doubled kidney. The anterior-posterior size of the pelvis of the lower half after removal of the pyelostomy was 16 mm. The child did not have any clinical and laboratory disease manifestations in the postoperative period. The described clinical case expands our understanding of the anatomy of obstruction of the pyeloureteral segment and hydronephrosis of the lower half of the duplex kidney. It enables us to plan surgical tactics, considering the possible intraoperative detection of the described anatomical configuration.

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First Experience of the Uretero-Ureteroanastomosis (Ureteropyeloanastomosis) in Children With Complete Ureteral Duplication

Cited by 6 publications

References 0 publications

Ureteral stump syndrome after ureteroureteroanastomosis, heminephrectomy and nephrectomy in children

Ureteral stump syndrome after ureteroureteroanastomosis, heminephrectomy and nephrectomy in children

Proximal ureterouretheroanastomosis in the treatment of kidney double in children

A rare variant of obstruction of the pyeloureteral segment of the lower half in a child with doubling of the upper urinary tract: Сase report

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