EFFECTIVENESS OF LAPAROSCOPIC REPAIR OF PRIMARY STRICTURES OF URETEROPELVIC JUNCTION


Дәйексөз келтіру

Толық мәтін

Ашық рұқсат Ашық рұқсат
Рұқсат жабық Рұқсат берілді
Рұқсат жабық Рұқсат ақылы немесе тек жазылушылар үшін

Аннотация

Aim. To evaluate the effectiveness of laparoscopic repair of primary strictures of ureteropelvic junction (UPJ) depending on baseline renal function of the ipsilateral kidney. Materials and methods. The study analyzed results of 134 patients (78 women and 56 men, age from 18 to 56 years) who underwent various types of laparoscopic repair of the UPJ stricture from 2012 to 2015. Depending on the surgical technique all patients were divided into three groups: group 1 (n=34) underwent spiral flap technique by Culp and DeWeerd, group 2 (n=59) - Anderson-Hynes pyeloplasty and group 3 (n=41) had antevasal dismembered pyeloplasty. All interventions ended with internal ureteral stenting for up to 6-8 weeks. Also, all patients were divided into three subgroups, depending on the degree of renal function deficiency - less than 25%, 25-50%, and 51-75%. Treatment effectiveness criteria included the following parameters: complete relief of the pain syndrome, a decrease in the degree of pyeloectasia, stabilization or improvement of the functional state of the renal parenchyma (according to radioisotope renography), and the absence of recurrence of the UPJ stricture. Results. The overall effectiveness of UPJ laparoscopic reconstruction was 94.7% (127 of 134). The effectiveness of the treatment was independent of the surgical technique, the initial thickness of the renal parenchyma and the degree of PCS dilatation. There was an inverse correlation between the treatment effectiveness the degree of kidney function deficiency. Conclusion. In patients with hydronephrosis secondary to UPJ stricture, the effectiveness of surgical treatment is mainly determined by its timeliness. The best treatment results were observed in patients with better renal function. The degree of renal function deficiency should be considered the main prognostic factor for the effectiveness of the forthcoming operation.

Толық мәтін

Рұқсат жабық

Авторлар туралы

N. Polyakov

N.A. Lopatkin Scientific Research Institute of Urology and Interventional Radiology - Branch of National Medical Research Radiological Center of the Ministry of Health of Russia

Email: nikp73@bk.ru
Ph.D., Senior Researcher of the Department of Reconstructive Urology Moscow, Russia

N. Keshishev

N.A. Lopatkin Scientific Research Institute of Urology and Interventional Radiology - Branch of National Medical Research Radiological Center of the Ministry of Health of Russia

Email: nkeshishev@gmail.com
Ph.D., Head of the Innovative Department Moscow, Russia

Sh. Gurbanov

N.A. Lopatkin Scientific Research Institute of Urology and Interventional Radiology - Branch of National Medical Research Radiological Center of the Ministry of Health of Russia

Email: gurbanovsh@gmail.com
Ph.D., Senior Researcher at the Department of Endourology Moscow, Russia

M. Grigor’eva

N.A. Lopatkin Scientific Research Institute of Urology and Interventional Radiology - Branch of National Medical Research Radiological Center of the Ministry of Health of Russia

Email: grinyamary@gmail.com
Ph.D., Junior Researcher at the Innovation Department Moscow, Russia

S. Serebryannyi

N.A. Lopatkin Scientific Research Institute of Urology and Interventional Radiology - Branch of National Medical Research Radiological Center of the Ministry of Health of Russia

Email: endourology@mail.ru
Ph.D., Senior Researcher at the Department of Endourology Moscow, Russia

A. Kazachenko

N.A. Lopatkin Scientific Research Institute of Urology and Interventional Radiology - Branch of National Medical Research Radiological Center of the Ministry of Health of Russia

Dr.Med.Sci., Deputy Director for Clinical Care, Chief Physician Moscow, Russia

B. Alekseev

N.A. Lopatkin Scientific Research Institute of Urology and Interventional Radiology - Branch of National Medical Research Radiological Center of the Ministry of Health of Russia

Email: byalekseev@mail.ru
Dr.Med.Sci., Prof., Deputy Director for Research and Clinical Care Moscow, Russia

Әдебиет тізімі

  1. Kletscher B.A., Segura J.W. Surgical management of UPJ obstruction in adults. AUA Update Series. 1996;XV:18.
  2. Kausik S., Segura J.W. Surgical management of ureteropelvic junction obstruction in adults. International Braz J Urol Official Journal of the Brazilian Society of Urology. 2003;29(1):3-10.
  3. Nishi M., Matsumoto K., Fujita T., Iwamura M. Improvement in Renal Function and Symptoms of Patients Treated with Laparoscopic Pyeloplasty for Ureteropelvic Junction Obstruction with Less than 20% Split Renal Function. Department of Urology, Kitasato University School of Medicine, Kanagawa, Japan. J Endourol. 2016 Oct 14.
  4. Kletscher B.A., Segura J. W. Surgical management of UPJ obstruction in adults. AUA Update Series. 1996;XV:18.
  5. Martov A.G., Gurbanov Sh.Sh., Mudraya I.S.: Evaluation of the contractile function of the upper urinary tract using multichannel impedance ureterography before and after endoureteropyelotomy. Urologiia. 2009;(4),:25-30.
  6. Martov A.G., Gurbanov Sh.Sh., Tokareva E.V., Shcherbinin S.N., Kornienko S.I. Comparative evaluation of the results of magnetic resonance urography and other diagnostic methods in patients with iatrogenic injury of the ureter and the ureteropelvic junction. Urologiia. 2009;(3):7-12
  7. Pavlov A.Yu., Pugachev A.G., Polyakov N.V., Lisenok A.A. Prognostic implications of surgical treatment of pediatric hydronephrosis. In: Plenum pravleniya Rossiiskogo obshchestva urologov. Materialy plenuma, Tyumen’, 24-27 maya 2005 g. Р. 147-148.
  8. Pavlov A.Yu., Polyakov N.V., Ignashin N.S., Golovanov S.A. Algorithm of diagnosis and treatment of obstructive uropathies of the upper urinary tract in children and adolescents. In: Plenum pravleniya Rossiiskogo obshchestva urologov. Materialy plenuma, Tyumen’, 24-27 maya 2005 g. p. 148-149.
  9. Wickham J.E., Kellet M.J. Percutaneous pyelolysis. Eur Urol. 1983;9:122-124.
  10. Martov A.G., Kvasha V.I. Percutaneous endopyelotomy. Urologiya i nefrologiya. 1990;6:22-25.
  11. Martov A.G., Ergakov D.V., Salyukov R.V., Gushchin B.L., Chernov N.A. X-ray guided endoscopic treatment of strictures of the upper urinary tract (A literature review). Urologiia. 2000;1:38-43.
  12. Chen W.N., Ye X.J., Liu S.J., Xiong L.L., Huang X.B., Xu., Wang X.F. Comparison of three surgical methods of ureteropelvic junction obstruction in therapeutic effect and complication. Beijing Da Xue Xue Bao. 2016;48(5):817-821.
  13. Corbett H.J., Mullassery D. Outcomes of endopyelotomy for pelviureteric junction obstruction in the paediatric population: A systematic review. J Pediatr Urol. 2015;11(6):328-336. doi: 10.1016/j.jpurol.2015.08.014.
  14. Lai W.R., Stewart C.A., Thomas R.: From Endopyelotomy to Robotic Pyeloplasty: What a Safari! J Endourol. 2016.
  15. Martov A.G., Gurbanov Sh.Sh., Stepanov V.S., Kornienko S.I. X-ray guided endoscopic diagnosis and treatment of iatrogenic injuries of the upper urinary tract. Urologiia. 2009;2:25-32.
  16. Zabirov K.I., Yarovoi S.K. Antibacterial prophylaxis for endoscopic surgical interventions in urology. Consilium medicum. 2010;7(12):51-54.
  17. Bondarenko S. G. A differentiated approach to the choice of the method of minimally invasive surgical correction of hydronephrosis: Ph.D. Thesis. Volgograd, 2007. 27 p.
  18. Komyakov B.K., Guliev B.G., Shibliev R.G. Endoscopic interventions for strictures of the upper urinary tract. Pervyi Ros. kongress po endourologii: tez. dokl. M., 2008. S. 83-85.
  19. Bansal P., Gupta A., Mongha R. et al. Laparoscopic versus open pyeloplasty: Comparison oftwo surgical approaches - a single centre experience of three years. J Minim Access Surg. 2008;4:76-79.
  20. Iwamura M., Soh S., Irie A. et al. Laparoscopic pyeloplasty for ureteropelvic junction obstruction: outcome of initial 12 procedures. Int J Urol. 2004;11:449-455.
  21. Juliano R.V., Mendonca R.R., Meyer F. et al. Long-term outcome of laparoscopic pyeloplasty: multicentric comparative study of techniques and accesses. J Laparoendosc Adv Surg Tech A. 2011;21:399-403.
  22. Abdel-Karim A.M., Fahmy, Moussa A., Rashad H., Elbadry M., Badawy H., Hammady A. Laparoscopic pyeloplasty versus open pyeloplasty for recurrent ureteropelvic junction obstruction in children. J Pediatr Urol. 2016. pii: S1477-5131(16)30186-3.
  23. Juliano R.V., Mendonça R.R., Meyer F., Rubinstein M., Lasmar M.T., Korkes F., Tavares A., Pompeo A.C., Tobias-Machado M. Long-term outcome of laparoscopic pyeloplasty: multicentric comparative study of techniques and accesses. J Laparoendosc Adv Surg Tech A. 2011;21(5):399-403.
  24. El-Hout Y., Licht C., Pippi Salle J.L. et al. Hypertension in children with poorly functioning unilateral kidney: predictors of resolution after nephrectomy. BJU Int. 2010;106:1376-1380.
  25. Autorino R., Eden C., El-Ghoneimi A. et al. Robot-assisted laparoscopic repair of ureteropelvic junction obstruction: A systematic review and metaanalysis. Eur Urol. 2014;65:430-452.
  26. Wagner M., Mayr J., Häcker F.M. Improvement of renal split function in hydronephrosis with less than 10 % function. Eur J Pediatr Surg. 2008;18:156-159.
  27. Bansal R., Ansari M.S., Srivastava A., Kapoor R. Long-term results of pyeloplasty in poorly functioning kidneys in the pediatric age group. J Pediatr Urol. 2012;8:25-28.
  28. Ortapamuk H., Naldoken S., Tekdogan U.Y., Aslan Y., Atan A. Differential renal function in the prediction of recovery in adult obstructed kidneys after pyeloplasty. Ann Nucl Med. 2003;17:663-668.

Қосымша файлдар

Қосымша файлдар
Әрекет
1. JATS XML
Жүктеу

© Bionika Media, 2017

Осы сайт cookie-файлдарды пайдаланады

Біздің сайтты пайдалануды жалғастыра отырып, сіз сайттың дұрыс жұмыс істеуін қамтамасыз ететін cookie файлдарын өңдеуге келісім бересіз.< / br>< / br>cookie файлдары туралы< / a>