Русский
Methods of the videoendoscopic correction of the ureters strictures
DOI: https://dx.doi.org/10.18565/urology.2020.2.41-45
N.B. Zabrodina, E.A. Gallyamov, A.V. Kovalenko, A.M. Sysoev, M.E. Bechteva, K.A. Ivantsov
Federal State-Funded Institution “Central Clinical Hospital of the Civil Aviation”, Moscow, Russian
The purpose of the study: a retrospective analysis of the results of patients treatment with ureteral strictures by evaluating the effectiveness of various methods of laparoscopic operations.
Materials and methods: a retrospective analysis of the treatment of 30 patients operated in the Central Hospital of Civil Aviations from 2013 to the present time with strictures of all departments of the ureters, except the pelvic-ureteral segment (LMS), was performed. The study included 18 women and 12 men. The age of patients was 54±8.1 years (29–79 years) for men and 51±8.5 years (28–74 years) for women. According to the results of x-ray examinations, the length of ureter stricture was determined, after that selected the tactics of surgical treatment. The study included patients who underwent intestinal plastics of the ureter, the operation Boari, ureterocystoanastomosis, ureteroureterostomy. All stages of surgical interventions were performed laparoscopically.
Results: 23 patients (76.66%) had a smooth postoperative period. A month after the operation, ureteral stents were removed. Attacks of acute pyelonephritis, relapses of the disease were not observed during the follow-up period from 7 months to 3 years. Possible complications are analyzed. In one case, after intestinal plastic surgery of the ureter in the postoperative period, the phenomena of small bowel obstruction were noted, which required surgical treatment in the volume of applying a bypass eunoascendoanastomosis «side by side». In 7 cases, anastomosis strictures were diagnosed in the postoperative period. In the 5 cases, after examination (CT of the urinary tract with contrast, antegrade ureteropyelography), the anastomosis was recognized compensated.
Conclusion: It is shown that all the necessary range of operations can be performed by laparoscopic method while preserving all the advantages of low-trauma access.
Materials and methods: a retrospective analysis of the treatment of 30 patients operated in the Central Hospital of Civil Aviations from 2013 to the present time with strictures of all departments of the ureters, except the pelvic-ureteral segment (LMS), was performed. The study included 18 women and 12 men. The age of patients was 54±8.1 years (29–79 years) for men and 51±8.5 years (28–74 years) for women. According to the results of x-ray examinations, the length of ureter stricture was determined, after that selected the tactics of surgical treatment. The study included patients who underwent intestinal plastics of the ureter, the operation Boari, ureterocystoanastomosis, ureteroureterostomy. All stages of surgical interventions were performed laparoscopically.
Results: 23 patients (76.66%) had a smooth postoperative period. A month after the operation, ureteral stents were removed. Attacks of acute pyelonephritis, relapses of the disease were not observed during the follow-up period from 7 months to 3 years. Possible complications are analyzed. In one case, after intestinal plastic surgery of the ureter in the postoperative period, the phenomena of small bowel obstruction were noted, which required surgical treatment in the volume of applying a bypass eunoascendoanastomosis «side by side». In 7 cases, anastomosis strictures were diagnosed in the postoperative period. In the 5 cases, after examination (CT of the urinary tract with contrast, antegrade ureteropyelography), the anastomosis was recognized compensated.
Conclusion: It is shown that all the necessary range of operations can be performed by laparoscopic method while preserving all the advantages of low-trauma access.
