Characteristics of hydronephrosis due to obstruction of the pyeloureteral segment combined with dorsal rotation of the kidney
- Authors: Sizonov VV1, Kogan MI1, Sizonov VV1, Kogan MI1
-
Affiliations:
- Issue: No 4 (2011)
- Pages: 3-7
- Section: Articles
- URL: https://journals.eco-vector.com/1728-2985/article/view/279166
- ID: 279166
Cite item
Full Text
Abstract
Rotation of the kidney is caused by its dystopia and abnormal blood circulation. Dorsal rotation of the kidney in normal position is a rare anomaly. We studied a clinical course, evidence obtained at renosonography, excretory urography, computed tomography, radionuclide investigation, anatomic variants of pyeloureteral segment obstruction in female patients with right-side hydronephrosis in the presence of dorsal rotation of the kidney before and after pyeloplasty. We made pyeloplasty for obstruction of the pyeloureteral segment in 266 patients in 2001-2009. Hydronephrosis was accompanied with dorsal rotation of the kidney in 21 (7.9%) cases. Surgical approaches to the pelviureteral segment are characterized. The dorsal approach is a good alternative to standard subcostal approach, provides good visualization in creation of anastomosis, significantly reduces distance from the skin cut to pyeloureteral segment and offers the best cosmetic result. In subcostal approach mobilization of the pelvis and pyeloureteral segment is preferable on the posterior surface of the kidney. A laparoscopic transperitoneal approach is not justified as it implies wide mobilization of the kidney, the anastomosis is created in extremely limited space.
References
- Ingole I.,Ghosh S. Laterally rotated kidney - a rare congenital anomaly. J. Anat. Soc. india 2005; 54(1): 19-21.
- Das S., Amar A. Ureteropelvic junction with associated renal anomalies. J. Urol. (Baltimore). 1984; 131: 872-878.
- Хофер М. Ультразвуковая диагностика. Базовый курс. М.: Мед. лит.; 2006.
- Fernbach S. K., Maizels M., Conway J. J. Ultrasound grading of hydronephrosis: introduction to the system used by the Society for Fetal Urology. Pediatr Radiol. 1993; 23(6): 478-480.
- Choo K. L., Borzi P. A. Surgical correction of pelviureteric junction obstruction in childhood - dorsal lumbotomy approach and selective internal ureteric stenting. Pediatr. Surg. Int. 2001; 17: 152-156.
- Kumar R., Smith G. Dorsal lumbotomy incision for pediatric pyeloplasty - a good alternative. Pediatr. Surg. Int. 1999; 15(8): 562-564.
- Onol F. F., A., Kose O., Onol S. Y. Short stay pyeloplasty with transverse dorsal lumbotomy incision: our 10-year experience. Urology 2009; 74(6): 1309-1312.