Horizontal pyeloureteral anastomosis in patients with UPJ obstruction has anatomical and functional advantages over vertical anastomosis

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Аннотация

Introduction. The standard approach to the treatment of short ureteropelvic junction (UPJ) obstruction is the Anderson-Hynes procedure. Despite its high efficiency and low complication rate, there are ongoing studies which study the modification of the procedure using open, laparoscopic, and robotic approaches.

Aim. To describe a modified pyeloplasty technique with an assessment of the anatomical and functional results in comparison with the Anderson-Hynes procedure.

Materials and methods. The results of 1,768 procedures for short UPJ obstruction and hydronephrosis performed using open (804), laparoscopic (888), and robotic (76) approaches in children and adults from 2000 to 2023 are presented in the article. A technique for horizontal ureteropyeloanastomosis after UPJ resection was developed by V.V. Sizonov and M.I. Kogan. A comparative analysis of the anatomical and functional results of vertical (standard) and horizontal anastomoses of the ureteral pelvis was performed using mathematical methods of the theory of hydrodynamics, and imaging studies after 12 months of follow-up.

Results. Horizontal anastomosis of the renal pelvis and ureter increases the passage of urine by 19.75% compared to vertical anastomosis. Horizontal anastomosis is less tense after resection of the ureteral pelvis. Postoperative dynamics of the anteroposterior size of the renal pelvis after horizontal anastomosis reliably demonstrates accelerated reduction compared to standard technique. Horizontal anastomosis is associated with a significantly higher increase in GFR compared to vertical anastomosis.

Conclusion. The author's technique of horizontal anastomosis between the ureter and pelvis has reliable anatomical and functional advantages over the Anderson-Hynes technique when performing open, laparoscopic and robotic pyeloplasty.

Толық мәтін

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Авторлар туралы

M. Kogan

Rostov State Medical University

Хат алмасуға жауапты Автор.
Email: dept_kogan@mail.ru
ORCID iD: 0000-0002-1710-0169

PhD, MD, Professor, Honored Scientist of Russian Federation, Head of the Department of Urology and Human Reproductive Health with the Course of Pediatric Urology and Andrology

Ресей, Rostov-on-Don

V. Sizonov

Rostov State Medical University

Email: vsizonov@mail.ru
ORCID iD: 0000-0001-9145-8671

PhD, MD, Professor at the Department of Urology and Human Reproductive Health with the Course of Pediatric Urology and Andrology

Ресей, Rostov-on-Don

V. Medvedev

Kuban State Medical University

Email: medvedev_vl@mail.ru
ORCID iD: 0000-0001-8335-2578

PhD, MD, Professor, Head of the Department of Urology

Ресей, Krasnodar

G. Palaguta

Scientific and Research Institute of Regional Clinical Hospital №1 named after Prof. S.V. Ochapovsky

Email: palaguta83@gmail.com
ORCID iD: 0000-0002-3462-8766

urologist at the Urologic Department No. 1

Ресей, Krasnodar

Әдебиет тізімі

  1. Anderson J.C., Hynes W. Retrocaval ureter: a case diagnosed pre-operatively and treated successfully by a plastic operation. Br. J. Urol. 1949;21:209–2014.
  2. Chamie K, Tanaka ST, Hu B, Kurzrock EA. Short stay pyeloplasty: variables affecting pain and length of stay. J Urol. 2008;179(4):1549–1552.
  3. Seixas-Mikelus S.A., Jenkins L.C., Williot P., Greenfield S.P. Pediatric pyeloplasty: comparison of literature meta-analysis of laparoscopic and open techniques with open surgery at a single institution. J Urol. 2009;182(5):2428–2432.
  4. Aboulker P., Boccon–Gibod L., Olier C.. Techniques chirurgicales courantes en urologie. Flammarion Medecine – Sciences, 1974.
  5. Gillenwater J.Y., Grayhack J.T., Howards S.S., Duckett J.W. Adult and pediatric urology. Vol.1 Second Edition. Mosby Year Book. 1991.
  6. Hinman F. Operative urology.Geotar–Med. 2001. Russian (Хинман Ф. Оперативная урология.Гэотар–Мед. 2001).
  7. Weiss R.M., George N. J.R., O’Reilly P.H. Comprehensive Urologe. Mosby. 2001.
  8. Bishoff J.T., Kavoussi L.R. Atlas Laparoscopic Urologic Surgery. Saunders Elsevier. 2007.
  9. Hinman F., Jr., L.S. Baskin. Hinman’s atlas of pediatric urologic surgery. Sec. ed. Saunders Elsevier. 2009.
  10. Kogan M.I., Sizonov V.V. Etudes of diagnosis and surgery of hydronephrosis. Rostov-on-Don. IP Popov K.R., 2019. 208 p. Russian (Коган М.И., Сизонов В.В. Этюды диагностики и хирургии гидронефроза. Ростов-на-Дону. ИП Попов К.Р., 2019. 208 с.).
  11. Sizonov V.V., Romaneev A.B. Laparoscopic pyeloplasty with manual assistance for hydronephrosis in children. Pediatric surgery. 2011;1:32–34. Russian (Сизонов В.В., Романеев А.Б. Лапароскопическая пиелопластика с ручным ассистированием при гидронефрозе у детей. Детская хирургия. 2011;1:32–34).
  12. Sizonov V.V., Kogan M.I. Laparoscopic pyeloplasty in children. Endoscopic surgery. 2011;6:47–50. Russian (Сизонов В.В., Коган М.И. Лапароскопическая пиелопластика у детей. Эндоскопическая хирургия. 2011;6:47–50).
  13. Tanaka S.T., Grantham J.A., Thomas J.C., et al. A comparison of open vs laparoscopic pediatric pyeloplasty using the pediatric health information system database – do benefits of laparoscopic approach recede at younger ages? J Urol. 2008;180:1479–1485.
  14. Minnillo B.J., Cruz J.A., Sayao R.H. et al. Long-term experience and outcomes of robotic assisted laparoscopic pyeloplasty in children and young adults. J Urol. 2011;185:1455–1460.
  15. Ficarra V., Iannetti A., Vianello F., Mottrie A. Different pyeloplasty approaches, similar excellent results. European Urology. 2014;65(2):453–454.
  16. Sida Cheng, Xinfei Li, Kunlin Yang, Shengwei Xiong, Ziao Li, Hongjian Zhu, Peng Zhang,c Xuechao Li, Hua Guan, Zhihua Li, Han Hao, Lei Zhang, Xuesong Li, Liqun Zhou. Modified Laparoscopic and Robotic Flap Pyeloplasty for Recurrent Ureteropelvic Junction Obstruction with a Long Proximal Ureteral Stricture: The “Wishbone” Anastomosis and the “Ureteral Plate” Technique. Urol Int 2021;105:642–649. doi: 10.1159/000512994
  17. Ce Han, Lifei Ma, Pin Li, Jia’nan Wang, Xiaoguang Zhou, Tian Tao, Hualin Cao , Yuandong Tao , Yunjie Yang , Yang Zhao, Weiwei Zhu, Tao Guo, Xuexue Lyu, Ran Zhuo and Huixia Zhou. Modified robotic-assisted laparoscopic pyeloplasty in children for ureteropelvic junction obstruction with long proximal ureteral stricture: The “double-flap” technique. Original research article Front. Pediatr. 2022;10. https://doi.org/10.3389/fped.2022.964147
  18. Braga L.H.P., Pace K., DeMaria J., Lorenzo A.J. Systematic review and meta-analysis of robotic-assisted versus conventional laparoscopic pyeloplasty for patients with ureteropelvic junction obstruction: effect on operative time, length of hospital stay, postoperative complications, and success rate. Eur Urol. 2009;56:848–858.
  19. Passerotti C.C., Passerotti A.M., Dall’Oglio M.F., et al. Comparing the quality of the suture anastomosis and the learning curves associated with performing open, freehand, and robotic-assisted laparoscopic pyeloplasty in a swine animal model. J Am Coll Surg, 2009;208:576–586.
  20. Autorino R., Eden C., El-Ghoneimi A. et al. Robot-assisted and laparoscopic repair of ureteropelvic junction obstruction: a systematic review and meta-analysis. Eur Urol. 2014;65:430–452.
  21. Radfar M.H., Afyouni A., Shakiba B., Hamedanchi S., Zare Ali. A New Touchless Technique for Suturing in Transperitoneal Laparoscopic Pyeloplasty. Journal of laparoendoscopic & advanced surgical techniques. 2019;29(4):519–522.

Қосымша файлдар

Қосымша файлдар
Әрекет
1. JATS XML
2. Fig. 1. Anderson-Hynes technique for LMS plasty

Жүктеу (147KB)
3. Fig. 2. Stages of surgery with horizontal ureteropieloanastomosis technique

Жүктеу (127KB)
4. Fig. 3. Schemes of anastomoses and fluid flow through the LMS (A - horizontal anastomosis, B - vertical anastomosis)

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5. Fig. 4. Schematics of vertical and horizontal anastomosis (A and C, B and D - connection points at anastomosis)

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6. Fig. 5. Mean values of pelvic RPE in children of groups 1 and 2

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