LAPAROSCOPIC PLASTIC WITH PRIMARY STRICTURES OF THE URETEROPELVIC SEGMENT

Determination of indications for performing reconstructive and plastic surgical interventions in stricture of UPS is a difficult task. When making an incorrect decision, the treatment can be ineffective. Functional and anatomical preservation of the kidney can significantly affect the outcome of the...

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Main Authors: N. V. Polyakov, N. G. Keshishev, M. V. Gurbanov, M. V. Grigoryeva, L. D. Arustamov, A. V. Kazachenko, B. Ya. Alekseev
Format: Article
Language:Russian
Published: QUASAR, LLC 2017-12-01
Series:Исследования и практика в медицине
Subjects:
Online Access:https://www.rpmj.ru/rpmj/article/view/215
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author N. V. Polyakov
N. G. Keshishev
M. V. Gurbanov
M. V. Grigoryeva
L. D. Arustamov
A. V. Kazachenko
B. Ya. Alekseev
author_facet N. V. Polyakov
N. G. Keshishev
M. V. Gurbanov
M. V. Grigoryeva
L. D. Arustamov
A. V. Kazachenko
B. Ya. Alekseev
author_sort N. V. Polyakov
collection DOAJ
description Determination of indications for performing reconstructive and plastic surgical interventions in stricture of UPS is a difficult task. When making an incorrect decision, the treatment can be ineffective. Functional and anatomical preservation of the kidney can significantly affect the outcome of the operation.Purpose. Evaluation of the effectiveness of laparoscopic plastic surgery of stricture of UPS, depending on the anatomical and functional state of the ipsilateral kidney.Material and method. The results of treatment of 134 patients, who underwent for the period from 2012 to 2015 the different types of reconstructive surgical interventions for stricture of the pelvic-ureteral segment (Calp de Virde scrappy plastic surgery, Andersen-Heinz ureteropyelanastomosis, and antineoplastic ureteropyeloanastomosis), were analyzed. To analyze the effectiveness of the treatment, in the preand postoperative period, the following parameters were evaluated: the presence of pain syndrome, the presence of pyeloectasia, the functional state of the renal parenchyma (according to radioisotope renography), and the absence of recurrence of the UPS stricture.Result. The overall efficacy of laparoscopic UPS reconstruction was 94.7%. The results of treatment did not depend on the chosen technique of operative intervention. In this case, the effectiveness of the treatment was dependent on the initial deficiency of kidney function: the best results were seen in patients with kidney function deficiency of less than 25%, and the proportion of ineffective interventions was highest among patients with a deficit of more than 75%. The degree of dilatation of the pelvis in the postoperative period was also associated with preoperative indicators of kidney function deficiency, this may be due to the presence of cup-pelvis-plating system atony.Conclusion. Thus, the results of our work demonstrated the high efficiency of laparoscopic plastics of UPS. The effective- ness of treatment is determined by the timeliness of the intervention. As a basic prognostic criterion for the effective- ness of the forthcoming intervention, the degree of deficiency of the kidney function should be considered.
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spelling doaj.art-2f527e413d83449480e371f0e53b26952025-03-02T12:44:07ZrusQUASAR, LLCИсследования и практика в медицине2410-18932017-12-0144101710.17709/2409-2231-2017-4-4-1165LAPAROSCOPIC PLASTIC WITH PRIMARY STRICTURES OF THE URETEROPELVIC SEGMENTN. V. Polyakov0N. G. Keshishev1M. V. Gurbanov2M. V. Grigoryeva3L. D. Arustamov4A. V. Kazachenko5B. Ya. Alekseev6N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology – Branch of the National Medical Radiology Research Centre of the Ministry of Health of the Russian FederationN. Lopatkin Scientific Research Institute of Urology and Interventional Radiology – Branch of the National Medical Radiology Research Centre of the Ministry of Health of the Russian FederationN. Lopatkin Scientific Research Institute of Urology and Interventional Radiology – Branch of the National Medical Radiology Research Centre of the Ministry of Health of the Russian FederationN. Lopatkin Scientific Research Institute of Urology and Interventional Radiology – Branch of the National Medical Radiology Research Centre of the Ministry of Health of the Russian FederationN. Lopatkin Scientific Research Institute of Urology and Interventional Radiology – Branch of the National Medical Radiology Research Centre of the Ministry of Health of the Russian FederationN. Lopatkin Scientific Research Institute of Urology and Interventional Radiology – Branch of the National Medical Radiology Research Centre of the Ministry of Health of the Russian FederationN. Lopatkin Scientific Research Institute of Urology and Interventional Radiology – Branch of the National Medical Radiology Research Centre of the Ministry of Health of the Russian FederationDetermination of indications for performing reconstructive and plastic surgical interventions in stricture of UPS is a difficult task. When making an incorrect decision, the treatment can be ineffective. Functional and anatomical preservation of the kidney can significantly affect the outcome of the operation.Purpose. Evaluation of the effectiveness of laparoscopic plastic surgery of stricture of UPS, depending on the anatomical and functional state of the ipsilateral kidney.Material and method. The results of treatment of 134 patients, who underwent for the period from 2012 to 2015 the different types of reconstructive surgical interventions for stricture of the pelvic-ureteral segment (Calp de Virde scrappy plastic surgery, Andersen-Heinz ureteropyelanastomosis, and antineoplastic ureteropyeloanastomosis), were analyzed. To analyze the effectiveness of the treatment, in the preand postoperative period, the following parameters were evaluated: the presence of pain syndrome, the presence of pyeloectasia, the functional state of the renal parenchyma (according to radioisotope renography), and the absence of recurrence of the UPS stricture.Result. The overall efficacy of laparoscopic UPS reconstruction was 94.7%. The results of treatment did not depend on the chosen technique of operative intervention. In this case, the effectiveness of the treatment was dependent on the initial deficiency of kidney function: the best results were seen in patients with kidney function deficiency of less than 25%, and the proportion of ineffective interventions was highest among patients with a deficit of more than 75%. The degree of dilatation of the pelvis in the postoperative period was also associated with preoperative indicators of kidney function deficiency, this may be due to the presence of cup-pelvis-plating system atony.Conclusion. Thus, the results of our work demonstrated the high efficiency of laparoscopic plastics of UPS. The effective- ness of treatment is determined by the timeliness of the intervention. As a basic prognostic criterion for the effective- ness of the forthcoming intervention, the degree of deficiency of the kidney function should be considered.https://www.rpmj.ru/rpmj/article/view/215ups plastic surgeryups stricturelaparoscopic interventions on the upper urinary tractups flap plastic by calp de virdeups plastic by andersen-heinzantevasal ureteropyeloanastomosis
spellingShingle N. V. Polyakov
N. G. Keshishev
M. V. Gurbanov
M. V. Grigoryeva
L. D. Arustamov
A. V. Kazachenko
B. Ya. Alekseev
LAPAROSCOPIC PLASTIC WITH PRIMARY STRICTURES OF THE URETEROPELVIC SEGMENT
Исследования и практика в медицине
ups plastic surgery
ups stricture
laparoscopic interventions on the upper urinary tract
ups flap plastic by calp de virde
ups plastic by andersen-heinz
antevasal ureteropyeloanastomosis
title LAPAROSCOPIC PLASTIC WITH PRIMARY STRICTURES OF THE URETEROPELVIC SEGMENT
title_full LAPAROSCOPIC PLASTIC WITH PRIMARY STRICTURES OF THE URETEROPELVIC SEGMENT
title_fullStr LAPAROSCOPIC PLASTIC WITH PRIMARY STRICTURES OF THE URETEROPELVIC SEGMENT
title_full_unstemmed LAPAROSCOPIC PLASTIC WITH PRIMARY STRICTURES OF THE URETEROPELVIC SEGMENT
title_short LAPAROSCOPIC PLASTIC WITH PRIMARY STRICTURES OF THE URETEROPELVIC SEGMENT
title_sort laparoscopic plastic with primary strictures of the ureteropelvic segment
topic ups plastic surgery
ups stricture
laparoscopic interventions on the upper urinary tract
ups flap plastic by calp de virde
ups plastic by andersen-heinz
antevasal ureteropyeloanastomosis
url https://www.rpmj.ru/rpmj/article/view/215
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AT mvgrigoryeva laparoscopicplasticwithprimarystricturesoftheureteropelvicsegment
AT ldarustamov laparoscopicplasticwithprimarystricturesoftheureteropelvicsegment
AT avkazachenko laparoscopicplasticwithprimarystricturesoftheureteropelvicsegment
AT byaalekseev laparoscopicplasticwithprimarystricturesoftheureteropelvicsegment