Shelfo S W, Keller M S, Weiss R M
Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, USA.
J Urol. 1997 Apr;157(4):1420-2.
In duplex renal systems with a normal upper pole collecting system, and a lower pole collecting system with reflux and ureteropelvic junction obstruction or a kink at the ureteropelvic junction (that is reflux with trapping), treatment must address reflux and obstruction. We reviewed the results of ipsilateral pyeloureterostomy as a single corrective procedure.
We retrospectively reviewed our experience with 10 children who had complete ureteral duplication with lower pole reflux (grades III to V) and associated lower pole ureteropelvic junction obstruction or a ureteral kink with trapping. All patients were treated with ipsilateral end-to-side pyeloureterostomy. Followup ranged from 1 to 14 years.
All patients had a good postoperative result, there have been no immediate or long-term complications and no subsequent surgical procedure was needed. All patients had continued lower pole renal growth with good function, 9 had resolution or a marked decrease in pelvicaliceal dilatation and none had evidence of obstruction.
Ipsilateral end-to-side pyeloureterostomy for treating reflux into the lower moiety of a duplicated collecting system with associated ureteropelvic junction obstruction or a kink appears to be a single, safe corrective procedure that simultaneously manages vesicoureteral reflux and relieves the proximal obstructive process.
在具有正常上极集合系统、伴有反流以及输尿管肾盂连接处梗阻或输尿管肾盂连接处扭结（即反流伴潴留）的下极集合系统的重复肾系统中，治疗必须解决反流和梗阻问题。我们回顾了同侧肾盂输尿管吻合术作为单一矫正手术的结果。
我们回顾性分析了10例患有完全性输尿管重复畸形且下极反流（III至V级）以及相关下极输尿管肾盂连接处梗阻或输尿管扭结伴潴留的儿童患者的治疗经验。所有患者均接受了同侧端侧肾盂输尿管吻合术。随访时间为1至14年。
所有患者术后效果良好，无近期或远期并发症，无需后续手术。所有患者下极肾脏持续生长且功能良好，9例患者肾盂肾盏扩张得到缓解或明显减轻，无一例有梗阻迹象。
同侧端侧肾盂输尿管吻合术用于治疗重复集合系统下部分的反流以及相关的输尿管肾盂连接处梗阻或扭结，似乎是一种单一、安全的矫正手术，可同时处理膀胱输尿管反流并缓解近端梗阻过程。
