СРАВНИТЕЛЬНЫЙ АНАЛИЗ ЭФФЕКТИВНОСТИ ТУБУЛОПЛАСТИКИ ЛОХАНКИ И АНТЕВАЗАЛЬНОГО ПИЕЛОУРЕТЕРОАНАСТОМОЗА У ПАЦИЕНТОВ С ГИДРОНЕФРОЗОМ НА ПОЧВЕ ДОБАВОЧНЫХ НИЖНЕПОЛЯРНЫХ СОСУДОВ

Demchenko V. N., Schukin D. V., Khareba G. G., Antonyan I. M., Maltsev A. V. COMPARATIVE ANALYSIS OF EFFICIENCY OF THE TUBULOPLASTY OF THE PIPA AND ANTEVASAL PYELOURETERANASTOMOSIS IN PATIENTS WITH HYDRONEPHROSIS ON THE SOIL OF ADDITIONAL LOW-POLAR VESSELS. Актуальні проблеми транспортної медицини / Actual problems of transport medicine / 2020;1(59):72-80. ISSN 1818-9385

DOI http://dx.doi.org/10.5281/zenodo.3744373 

http://aptm.org.ua

COMPARATIVE ANALYSIS OF EFFICIENCY OF THE TUBULOPLASTY OF THE PIPA AND ANTEVASAL PYELOURETERANASTOMOSIS IN PATIENTS WITH HYDRONEPHROSIS ON THE SOIL OF ADDITIONAL LOW-POLAR VESSELS

Demchenko V. N., Schukin D. V., Khareba G. G., Antonyan I. M.,

Maltsev A. V.

Kharkov National Medical University

Kharkov Medical Academy of Postgraduate Education

We present a comparative assessment of the results of tubuloplasty (TP) of the pelvis and antevasal pyeloureteral anastomosis (APAA) in patients with hydronephrosis and additional vessels to the lower pole of the kidney.

The study included 84 patients who were divided into two groups: I - patients who underwent reconstruction of the ureteropelvic segment (UPS) using a tubularized pelvis flap (n = 48 / 57.1%) and II - patients who used antevasal pyeloureteroanastomosis (n = 36 / 42.9%). The patients included only with primary operations.

The length of the pelvic flap in the tubuloplasty group varied from 2.5 to 6.0 cm and reached an average of 3.4 ± 0.8 cm. The total frequency of intraoperative complications did not exceed 1.2% (in the TP group). Early postoperative complications were observed in 15.5% of patients (Clavien-Dindo gradation <3). There were no significant differences in this parameter in the two studied groups. The levels of good and satisfactory results in the TP group respectively reached 95.8% and 4.2% with the complete absence of bad results and were better than in the APAU group. Two poor results were recorded only in patients of the second group.

Surgical correction of UPS with the tubular flap of the pelvis is a highly effective and safe method for reconstruction of the upper urinary tract. We recommend its use in patients with hydronephrosis associated with ureterovasal conflict.

Key words: ureter reconstruction; reconstruction of the ureteropelvic segment; pyeloplasty with a tubular flap