Influence of significant difference in diameters of ureters on the possibility and effectiveness of ureteroureterostomy in the treatment of obstructive uropathies of the duplicated kidney

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BACKGROUND: Laparoscopic ureteroureterostomy is increasingly used as a surgical correction method for obstructive uropathies of the duplicated kidney. A complicating factor for this technique may be a significant difference between the diameters of the ureters.

AIM: This study aimed to analyze the effectiveness and safety of laparoscopic ureteroureterostomy in patients with obstructive uropathies of the duplicated kidney with a twofold or more difference in ureter diameters.

MATERIALS AND METHODS: Among 14 children who underwent laparoscopic ureteroureterostomy for obstructive uropathies of the duplicated kidney at Almazov National Medical Research Centre between 2021 and 2023, in 10 patients (71.4%), the diameter of the “donor” ureter exceeded the diameter of the “recipient” ureter two times or more.

RESULTS: In most patients, the indication for surgery was obstructive megaureter of the segment. All patients underwent laparoscopic ureteroureterostomy, proximal in 90% of cases and distal in one child. One of five patients underwent transurethral resection of the ureterocele as the first stage of operative treatment. The only complication observed in the postoperative period in the presented patients was a stent-associated urinary tract infection, which was treated conservatively. One child (10%) required ureter reimplantation with stump resection after ureteroureterostomy.

CONCLUSIONS: Laparoscopic ureteroureterostomy is a safe and effective method for surgical correction of obstructive uropathies of the duplicated kidney although a significant difference is noted between the diameters of the “donor” and “recipient” ureters. This factor does not reduce the effectiveness of ureteroureterostomy and does not lead to an increased risk of postoperative complications and reoperations. Thus, laparoscopic ureteroureterostomy can be used in patients with obstructive uropathies of the duplicated kidney.

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作者简介

Iliya Kagantsov

Almazov National Medical Research Centre; North-Western State Medical University named after I.I. Mechnikov

Email: ilkagan@rambler.ru
ORCID iD: 0000-0002-3957-1615
SPIN 代码: 7936-8722
Scopus 作者 ID: 55358760000

Dr. Sci. (Medicine), Professor

俄罗斯联邦, Saint Petersburg; Saint Petersburg

Evgeniya Kondrateva

Almazov National Medical Research Centre; North-Western State Medical University named after I.I. Mechnikov

编辑信件的主要联系方式.
Email: zhenya-muz@mail.ru
ORCID iD: 0000-0001-5435-8487
SPIN 代码: 4818-9170

MD

俄罗斯联邦, Saint Petersburg; Saint Petersburg

Svetlana Karavaeva

North-Western State Medical University named after I.I. Mechnikov; Children’s City Multidisciplinary Clinical Specialized Center оf High Medical Technologies

Email: swetl.karawaewa2015@yandex.ru
ORCID iD: 0000-0001-5884-9128
SPIN 代码: 4224-5532

MD, Dr. Sci. (Medicine), Professor

俄罗斯联邦, Saint Petersburg; Saint Petersburg

Anna Sukhotskaya

Almazov National Medical Research Centre

Email: anna.a.sukhotskaya@gmail.ru
ORCID iD: 0000-0002-8734-2227
SPIN 代码: 6863-7436
Scopus 作者 ID: 57215907643

MD, Cand. Sci. (Medicine)

俄罗斯联邦, Saint Petersburg

Lidiya Smyslova

Almazov National Medical Research Centre

Email: vladi-lidiya@yandex.ru

MD

俄罗斯联邦, Saint Petersburg

Tatiana Pervunina

Almazov National Medical Research Centre

Email: ptm.pervunina@yandex.ru
ORCID iD: 0000-0001-9948-7303
SPIN 代码: 3288-4986
Scopus 作者 ID: 56572907100

Dr. Sci. (Med), Director of the Institution of Perinatology and Pediatrics

俄罗斯联邦, Saint Petersburg

参考

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2. Figure. Intravenous urograms of a patient with an obstructive upper segment megaureter, vesicoureteral reflux into the lower segment of the left double kidney, and ureterocele before (a) and 6 months after (b) ureteroureterostomy

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