Laparoscopic Transposition of Lower-Pole Kidney Crossing Vessels: 5-Years Follow-up Study

Document Type : Original Article (s)

Authors

1 Associate Professor, Department of Urology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Student of Medicine, Student Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Junction obstruction in the ureter is a high-prevalence disorder and its standard treatment is dismembered method. This study aimed to evaluate laparoscopic transposition of lower-pole kidney crossing vessels in patients with ureteropelvic junction obstruction, before and after surgery, in a 5-years follow-up study.Methods: In this cross-sectional study, 24 patients with lower pole crossing vessels underwent laparoscopic surgery of transposition of crossing vessel were enrolled. For patients, diethylene triamine pentacaetic acid (DTPA) scan was performed before, and 1 and 6 month after the surgery and they were followed yearly for 5 years.Findings: Twenty four patients with a mean age of 28.04 ± 12.99 years (58.3% male) and 3.29 ± 0.69 days of stay in hospital, suffering from stenosis of ureteropelvic junction were enrolled. Mean blood loss was 151.99 ± 7.48 ml. In all the patients, kidney function improved after the surgery (the Moffitt surgery: 100%).Conclusion: Laparoscopic transposition of aberrant vessels has a success rate of a hundred percent in improving the renal function and it also has the lowest rate of complications and hemorrhage. Further studies with control groups are recommended to compare the results of this method with older methods, especially in people under the age of 2 years.

Keywords

References

  1. Weiss DA, Kadakia S, Kurzweil R, Srinivasan AK, Darge K, Shukla AR. Detection of crossing vessels in pediatric ureteropelvic junction obstruction: Clinical patterns and imaging findings. J Pediatr Urol 2015; 11(4): 173-5.
  2. Calder AD, Hiorns MP, Abhyankar A, Mushtaq I, Olsen OE. Contrast-enhanced magnetic resonance angiography for the detection of crossing renal vessels in children with symptomatic ureteropelvic junction obstruction: comparison with operative findings. Pediatr Radiol 2007; 37(4): 356-61.
  3. Rigas A, Karamanolakis D, Bogdanos I, Stefanidis A, Androulakakis PA. Pelvi-ureteric junction obstruction by crossing renal vessels: clinical and imaging features. BJU Int 2003; 92(1): 101-3.
  4. Renjen P, Bellah R, Hellinger JC, Darge K. Pediatric urologic advanced imaging: techniques and applications. Urol Clin North Am 2010; 37(2): 307-18.
  5. Anderson JC, Hynes W. Retrocaval ureter; a case diagnosed pre-operatively and treated successfully by a plastic operation. Br J Urol 1949; 21(3): 209-14.
  6. Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA. Campbell-Walsh urology. 10th ed. Philadelphia, PA: Saunders; 2011.
  7. Cain MP, Rink RC, Thomas AC, Austin PF, Kaefer M, Casale AJ. Symptomatic ureteropelvic junction obstruction in children in the era of prenatal sonography-is there a higher incidence of crossing vessels? Urology 2001; 57(2): 338-41.
  8. Rooks VJ, Lebowitz RL. Extrinsic ureteropelvic junction obstruction from a crossing renal vessel: demography and imaging. Pediatr Radiol 2001; 31(2): 120-4.
  9. Hiorns MP. Imaging of the urinary tract: the role of CT and MRI. Pediatr Nephrol 2011; 26(1): 59-68.
  10. Olsen LH, Rawashdeh YF, Jorgensen TM. Pediatric robot assisted retroperitoneoscopic pyeloplasty: a 5-year experience. J Urol 2007; 178(5): 2137-41.
  11. Hellstrom J, Giertz G, Lindblom K. Pathogenesis and treatment of hydronephrosis. J Belge Urol 1951; 20(1): 1-6.
  12. Gundeti MS, Reynolds WS, Duffy PG, Mushtaq I. Further experience with the vascular hitch (laparoscopic transposition of lower pole crossing vessels): an alternate treatment for pediatric ureterovascular ureteropelvic junction obstruction. J Urol 2008; 180(4 Suppl): 1832-6.
  13. Villemagne T, Fourcade L, Camby C, Szwarc C, Lardy H, Leclair MD. Long-term results with the laparoscopic transposition of renal lower pole crossing vessels. J Pediatr Urol 2015; 11(4): 174-7.
  14. Simforoosh N, Tabibi A, Nouralizadeh A, Nouri-Mahdavi K, Shayaninasab H. Laparoscopic management of ureteropelvic junction obstruction by division of anterior crossing vein and cephalad relocation of anterior crossing artery. J Endourol 2005; 19(7): 827-30.
  15. de WD, Dik P, Lilien MR, Kok ET, de Jong TP. Hypertension is an indication for surgery in children with ureteropelvic junction obstruction. J Urol 2008; 179(5): 1976-8.
  16. Masood J, Panah A, Zaman F, Papatsoris AG, Buchholz N, Junaid I. Laparoscopic cranial plication in pelviureteral junction obstruction by aberrant lower pole artery. J Endourol 2009; 23(1): 7-10.
  17. Zhang X, Xu K, Fu B, Zhang J, Lang B, Ai X, et al. The retroperitoneal laparoscopic Hellström technique for pelvi-ureteric junction obstruction from a crossing vessel. BJU International 2007; 100(6): 1335-8.
  18. Singh RR, Govindarajan KK, Chandran H. Laparoscopic vascular relocation: alternative treatment for renovascular hydronephrosis in children. Pediatr Surg Int 2010; 26(7): 717-20.
  19. Smith JS, McGeorge A, Abel BJ, Hutchinson AG. The results of lower polar renal vessel transposition (the Chapman procedure) in the management of hydronephrosis. Br J Urol 1982; 54(2): 95-7.
  20. Tan HL. Laparoscopic Anderson-Hynes dismembered pyeloplasty in children. J Urol 1999; 162(3 Pt 2): 1045-7.
  21. Woo HH, Farnsworth RH. Dismembered pyeloplasty in infants under the age of 12 months. Br J Urol 1996; 77(3): 449-51.
  22. Chacko JK, Koyle MA, Mingin GC, Furness PD 3rd. The minimally invasive open pyeloplasty. J Pediatr Urol 2006; 2(4): 368-72.
  23. Tanaka ST, Grantham JA, Thomas JC, Adams MC, Brock JW 3rd, Pope JC. A comparison of open vs laparoscopic pediatric pyeloplasty using the pediatric health information system database--do benefits of laparoscopic approach recede at younger ages? J Urol 2008; 180(4): 1479-85.
  24. Simforoosh N, Javaherforooshzadeh A, Aminsharifi A, Soltani MH, Radfar MH, Kilani H. Laparoscopic management of ureteropelvic junction obstruction in pediatric patients: a new approach to crossing vessels, crossing vein division, and upward transposition of the crossing artery. J Pediatr Urol 2010; 6(2): 161-5.
  25. Nouralizadeh A, Simforoosh N, Basiri A, Tabibi A, Soltani MH, Kilani H. Laparoscopic management of ureteropelvic junction obstruction by division of the aberrant vein and cephalad relocation of the crossing artery: a long-term follow-up of 42 cases. J Endourol 2010; 24(6): 987-91.
  26. Godbole P, Mushtaq I, Wilcox DT, Duffy PG. Laparoscopic transposition of lower pole vessels--the 'vascular hitch': an alternative to dismembered pyeloplasty for pelvi-ureteric junction obstruction in children. J Pediatr Urol 2006; 2(4): 285-9.
Journal of Isfahan Medical School
Volume 35, Issue 420 - Serial Number 420
January and February 2017
Pages 128-134

Files

History

  • Receive Date: 24 December 2016
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics