Komyakov B K, Guliev B G, Idrisov Sh N, Shibliev R G
Department of Urology, I.I. Mechnikov North-Western State Medical University, St. Petersburg, Russia.
Scandinavia Clinic, St. Petersburg, Russia.
Urologiia. 2017 Jul(3):86-91. doi: 10.18565/urol.2017.3.86-91.
The article presents a case of laparoscopic antevasal correction of the retrocaval ureter in a 16 year old patient, who was admitted to the hospital with complaints of aching pain in the right lower back. His history was noteworthy of early age onset of intermittent fever accompanied by abdominal and lumbar pain. Blood count and urinalysis were within normal limits, and he was treated symptomatically. However, no renal ultrasound scan was done. Intravenous urography and MSCT showed a retrocaval ureter. The diagnosis was confirmed by retrograde ureteropyelography. With the patient placed in the lateral position, the right ureter was mobilized by transperitoneal access, transected and mobilized from under the inferior vena cava. Anterior uretero-ureteral anastomosis on the stent was performed, drainage was established. The operating time was 90 minutes, blood loss was 60 ml. There were no postoperative complications. Drainage was removed 2 days after surgery and the patient was discharged for outpatient treatment. The stent was removed 6 weeks postoperatively. Control urography showed normal function of both kidneys, no urodynamic abnormality of the upper urinary tract was identified.
本文介绍了一例16岁患者腹腔镜下腔后输尿管前路修复术的病例。该患者因右下背部隐痛入院。其病史值得注意的是早年出现间歇性发热并伴有腹部和腰部疼痛。血常规和尿常规均在正常范围内，给予对症治疗。然而，未进行肾脏超声检查。静脉肾盂造影和MSCT显示为腔后输尿管。逆行输尿管肾盂造影确诊。患者取侧卧位，经腹膜腔途径游离右侧输尿管，切断并从下腔静脉下方游离。在支架上进行输尿管-输尿管端端吻合，建立引流。手术时间90分钟，出血量60毫升。术后无并发症。术后2天拔除引流管，患者出院进行门诊治疗。术后6周拔除支架。对照肾盂造影显示双肾功能正常，未发现上尿路尿动力学异常。
