Correction of pelviureteral segment stenosis by Kuchere: the operative technique and results

Resumo

Efficacy of surgical correction of stenosed pelviureteral segment (SPS) in 30 patients with hydronephrosis was analysed. Twenty three patients have undergone extended resection of the extrarenal pelvis together with SPS. Repair of the pelviureteral segment in these patients was made by Kuchere technique. Histologic examination of resected SPS detected advanced sclerosis of all the layers of the ureteral and renal pelvis walls in chronic mucosal inflammation. The operative technique is described. Postoperative complications were absent. The control examination upon discharge and 1-15 year follow-up results registered good functioning of the operated-on kidney with rehabilitation of the calyceal-pelvic structure. Plastic operation was successful due to creation of a wide anastomosis between the resected renal pelvis and the ureter with obligatory renal drainage using nephrostoma. In other 4 cases of SPS strictures graft plastic operations were made. Good functional results were achieved in 3 patients. The long-term results favour resections and creation of pelviureteral anastomosis by Kuchere.