Kramer S A, Kelalis P P
J Urol (Paris). 1984;90(5):331-6.
Of 49 children with renal ectopy, 25 (51%) had hydronephrosis on excretory urography. Dilatation of the renal pelvis was the result of primary ureteropelvic junction obstruction (17 children), significant vesicoureteral reflux (6 children), or extrarenal pelves and calices with renal malrotation producing apparent ureteropelvic junction obstruction (2 children). Vesicoureteral reflux was a common finding in these patients, occurring in 52% of those with crossed renal ectopy and in 70% of those with pelvic kidney. The need for surgical intervention results from either (1) ureteropelvic junction obstruction secondary to high insertion of the ureter on the renal pelvis or (2) vesicoureteral reflux secondary to aberrant migration of the lower ureter. Most children with renal ectopy and ureteropelvic dilatation require surgical reconstruction at the renal level. In selected patients, ureterocalicostomy is an attractive alternative to conventional pyeloplasty and appears to afford improved drainage with superior results.
在49例异位肾患儿中，25例（51%）在排泄性尿路造影时存在肾积水。肾盂扩张是由原发性输尿管肾盂连接处梗阻（17例患儿）、显著的膀胱输尿管反流（6例患儿）或肾外肾盂和肾盏伴肾脏旋转不良导致的明显输尿管肾盂连接处梗阻（2例患儿）引起的。膀胱输尿管反流在这些患者中很常见，在交叉异位肾患者中发生率为52%，在盆腔肾患者中发生率为70%。手术干预的必要性源于以下两种情况之一：（1）输尿管在肾盂上高位插入继发的输尿管肾盂连接处梗阻，或（2）下段输尿管异常迁移继发的膀胱输尿管反流。大多数异位肾和输尿管肾盂扩张的患儿需要在肾脏层面进行手术重建。在部分患者中，输尿管肾盂造口术是传统肾盂成形术的一种有吸引力的替代方法，似乎能提供更好的引流效果，结果更佳。
