[Ipsilateral ureteroureterostomy. A safe alternative in complete duplicated collecting system with associated pathology]. / Uretero-ureteroanastomosis distal ipsilateral. Una alternativa segura en doble sistema renal completo con patología asociada.

In patients with complete double renal system with the involvement of only one system, there are several surgical alternatives for its resolution. Uretero-ureteral anastomosis has been presented as a good alternative, even in cases with atrophy of the affected system. OBJECTIVE: To report our experience in patients with complete double renal system with only one system affected, with the surgical technique of uretero-ureteral anastomosis. PATIENTS AND METHOD: Retrospective study of patients with double renal system with involvement of one of the systems, treated with uretero-ureteral anastomosis technique between January 2015 and May 2022. The variables of age, specific pathology of the affected system, preoperative study, days of hospitalization, postoperative complications (leakage, obstruction, infection), and follow-up time were evaluated. RESULTS: We analyzed 26 procedures in 25 patients, mean age 36.8 months (range: 8-80); 53.8% had ectopic ureter, 23% ureterocele, 11.5% sphincteric ureterocele, and 11.5% VUR of the lower system. All were studied preoperatively with urethrocystography and 65% with scintigraphy. 50% of the operated systems showed signs of renal atrophy. The average hospital stay was 2.2 days (range: 1-7). In an average follow-up of 26.5 months (range: 3-77), one patient presented leakage, no patient presented signs suggestive of obstruction, and one patient presented febrile urinary tract infection with persistent lower-grade reflux. CONCLUSION: In our experience, the uretero-ureteral anastomosis technique proved to be an easy and safe alternative to reproduce, with a success rate of 96%, 11% of grade I complications, and 4% of grade II complications according to the Clavien-Dindo classification.

Estenosis traqueal congénita, Serie clínica / Congenital tracheal stenosis

Introducción: La estenosis traqueal congénita (ETC) es una entidad clínica infrecuente, que se caracteriza por la presencia de anillos traqueales circulares completos, que determinan estrechez fija del lumen traqueal ocasionando dificultad respiratoria de grado variable. Objetivos: Comunicar 10 pacientes portadores de ETC, sus aspectos clinicos, morfológicos y alternativas en el tratamiento. Pacientes y Método: Se analizó retrospectivamente las formas de manifestación, exámenes diagnósticos y evolución de diez pacientes portadores de ETC diagnosticados entre los años 1998 y 2006. Resultados: Seis pacientes con síntomas respiratorios graves requirieron cirugía correctora de la traquea, uno falleció luego de un año, en el postoperatorio de una intervención cardiovascular. Cuatro pacientes con sintomatología respiratoria menor no requirieron corrección quirúrgica, uno falleció en el postoperatorio de una cirugía cardiaca. Conclusión: La ETC es una malformación potencialmente grave que requiere tratamiento quirúrgico en los pacientes sintomáticos con obstrucción severa de vía aérea. Los pacientes con síntomas leves pueden permanecer en control y no ser sometidos a cirugía correctora.

Congenital tracheal stenosis (CTS) constitutes an uncommon disease, characterized by the presence of complete tracheal rings that determine a fixed narrow tracheal lumen with different levels of respiratory distress. Objective: To expose 10 patients with CTS in relation to their morphological-clinical aspects and treatment alternatives. Method: Retrospective analysis of these patients diagnosed with CTS between 1998 and 2006, in terms of clinical evolution and diagnostic exams. Results: 6 patients with severe respiratory symptoms needed corrective tracheal surgery; one of them died one year later during cardiac surgery. 4 patients with mild respiratory symptoms did not require tracheal surgery; one of them died during cardiac surgery. Conclusion: CTS is a serious malformation that requires surgical treatment in those patients with severe airway obstruction. Patients with mild symptoms are observed closely without the need for surgery.