Urologic Clinic, Hospital das Clinicas, University of Sao Paulo, Brazil.
Int Braz J Urol. 2012 Mar-Apr;38(2):235-41; discussion 241. doi: 10.1590/s1677-55382012000200012.
Duplex system is one of the most common anomalies of upper urinary tract. Anatomical and clinical presentation determine its treatment. Usually, the upper moiety has a poor function and requires resection, but when it is not significantly impaired, preservation is recommended. Laparoscopic reconstruction with upper pole preservation is presented as an alternative treatment.
Four female patients with duplex system, one presenting with recurrent urinary tract infection and the others with urinary incontinence associated to infrasphincteric ectopic ureter, were treated. Surgical procedure envolved a laparoscopic ureteropyeloanastomosis of the upper pole ureter to the pelvis of the lower moiety, with prior insertion of a double J stent.
Surgical time varied from 120 to 150 minutes, with minimal blood loss in all cases. Follow-up varied from 15 to 30 months, with resolution of the clinical symptoms and preservation of the upper moiety function.
Laparoscopic ureteropyeloanatomosis is a feasible and safe minimally invasive option in the treatment of duplex system.
双肾盂输尿管畸形是上尿路最常见的异常之一。解剖和临床表现决定了其治疗方法。通常，上半部分功能较差，需要切除，但当功能受损不明显时，建议保留。腹腔镜保留肾盂重建术是一种替代治疗方法。
4 例女性双肾盂输尿管畸形患者，1 例反复尿路感染，另 3 例伴有下尿路低位异位输尿管伴尿失禁，均接受了治疗。手术包括腹腔镜上肾盂输尿管吻合术，将上肾盂输尿管吻合到下肾盂，术前插入双 J 支架。
手术时间为 120 至 150 分钟，所有病例出血量均较少。随访时间为 15 至 30 个月，临床症状缓解，上半部分功能保留。
腹腔镜肾盂输尿管吻合术是治疗双肾盂输尿管畸形的一种可行、安全的微创选择。
