安德森-海因斯肾盂成形术联合峡部切开及侧方固定术治疗儿童马蹄肾合并肾盂输尿管连接处梗阻
Anderson-Hynes pyeloplasty with isthmotomy and lateropexy in horseshoe kidneys with pelviureteric junction obstruction in children.
作者信息
Panda Shasanka Shekhar, Bajpai Minu, Jana Manisha, Baidya Dalim Kumar, Kumar Rakesh
机构信息
Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi India.
Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi India.
出版信息
Indian J Urol. 2014 Apr;30(2):161-3. doi: 10.4103/0970-1591.126897.
OBJECTIVE
The objective of this study was to evaluate the results of Anderson-Hynes pyeloplasty with isthmotomy and lateropexy in horseshoe kidney with pelviureteric junction obstruction (PUJO).
MATERIALS AND METHODS
Medical records of patients of horseshoe kidney with PUJO operated in our institute between June 1998 and June 2012 were reviewed. Anderson-Hynes pyeloplasty with isthmotomy and lateropexy was performed in all patients. The surgical outcome was evaluated with emphasis on the changes in degree of hydronephrosis by ultrasonography, renal drainage and function assessed by diuretic renal scans.
RESULTS
We studied the records of eight children of horseshoe kidney having unilateral PUJO. Obstruction was caused by a crossing lower-pole vessel in two cases, a high ureteral insertion in three and narrowing of the PUJ in three cases. Post-operative follow-up (median 4.4 years, range 18 months to 10 years) revealed improved renal function and good drainage in all cases. Hydronephrosis disappeared in 3, 4 showed Grade 1 and one showed Grade 2 hydronephrosis. All children are doing well and have no symptoms.
CONCLUSION
Anderson-Hynes pyeloplasty with isthmotomy and lateropexy is a highly effective and safe procedure for treating PUJO in horseshoe kidney in children.
目的
本研究的目的是评估采用峡部切开术和侧方固定术的安德森-海因斯肾盂成形术治疗马蹄肾合并肾盂输尿管连接处梗阻（PUJO）的效果。
材料与方法
回顾了1998年6月至2012年6月在我院接受手术的马蹄肾合并PUJO患者的病历。所有患者均接受了采用峡部切开术和侧方固定术的安德森-海因斯肾盂成形术。通过超声检查评估肾积水程度的变化，通过利尿肾扫描评估肾脏引流和功能，以此来评估手术效果。
结果
我们研究了8例单侧PUJO马蹄肾患儿的病历。梗阻原因包括2例下极血管交叉、3例输尿管高位插入和3例PUJ狭窄。术后随访（中位时间4.4年，范围18个月至10年）显示所有病例的肾功能均有改善且引流良好。3例肾积水消失，4例为1级，1例为2级肾积水。所有患儿情况良好，均无症状。
结论
采用峡部切开术和侧方固定术的安德森-海因斯肾盂成形术是治疗儿童马蹄肾PUJO的一种高效且安全的手术方法。
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