[Organ-preserving reconstructive operations in reflux into duplicated ureters in children]. / Organosokhraniaiushchie rekonstruktivnye operatsii pri refliukse v udvoennye mochetochniki u detei.

ABSTRACT

A total of 54 children, aged 9 mos--14 yrs were operated on for reflux in double ureters. Out of them 38 patients were with ureter duplex and 16 with ureter fissus in prevesical or intramural area. The surgery was indicated by the reflux, stages III-IV, into a single or both ureters or reflux, stage II, in the patients whose a one-year conservative treatment turned to be a failure. Both segments of morphologically competent kidney were preserved during the reconstructive surgery in 27 patients. Unsatisfactory results of resection and neoimplantation of the both ureters according to Politano-Leadbetter as a "united block" as well as of distal ureteroureteral anastomosis made surgeons abandon the techniques. For the recent 10 yrs the authors have used the Politano-Leadbetter technique of ureteropyelo- or pyelopyelo-anastomosis with the cutting out of the upper segment of the ureter, resection of the distal part of the ureteral low segment and its neoimplantation into the urinary bladder. 20 patients were operated on 7 with ureter duplex and 13 with prevesical or intramural ureter fissus. Unitype surgery was performed the resection and implantation of a lower ureter segment in patients with ureter duplex 7 cm of the distal area was resected, in those with ureter fissus a 2-3-cm resection was made proximately to the site of splitting. The outcomes were followed up for the period of 1 to 9 postsurgical years. The operation turned to be beneficial in 17 patients (85 per cent). In 3 patients nephroureterectomy was performed for the complications arisen renal hemorrhages (1); the obstruction of vesicoureteral anastomosis (1) and apostematous nephritis (1).(ABSTRACT TRUNCATED AT 250 WORDS)