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Hani OB, Halalsheh O, Mohammad Y, Yaseen AB, Khasawneh R, Al–Sheikh N, Al-Khalili M, Alomari MM. Crossed renal ectopia with an unusual form of fusion (inverted U shape) managed by novel approach – laparoscopic ureterocalicostomy. A case report. JOURNAL OF CLINICAL AND INVESTIGATIVE SURGERY 2021. [DOI: 10.25083/2559.5555/6.1.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Herein we present a case of crossed renal ectopia with an unusual type of fusion, discovered incidentally in a 11-year-old girl presented with recurrent urinary tract infections. Both kidneys were located on the right side of the body fused in their upper poles only, forming an inverted U shape. After reviewing the published data on this topic, we found that most of the described anomalies were within the six well-known types of fusion anomalies. This child had an unusual clinical presentation of severe hydronephrosis of the orthotopic kidney. A unique surgical technique to correct the pathology to be able to preserve the residual mass of that kidney was performed.
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Banthia R, Srivastava A, Singh UP, Lal H. Crossed unfused renal ectopia with pelviureteric junction obstruction associated with nephrolithiasis: a rare troublesome triad managed by robotic surgery. BMJ Case Rep 2021; 14:14/4/e237794. [PMID: 33832930 PMCID: PMC8039243 DOI: 10.1136/bcr-2020-237794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
We report a rare case of non-fused renal ectopia with pelviureteric junction obstruction and multiple pelvic and renal calculi thereby discussing vascular anatomy of the non-fused ectopic kidney along with robot assisted surgical management of this rare clinical entity which amounts for good preoperative workup for best surgical and clinical outcome.
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Affiliation(s)
- Ravi Banthia
- Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar pradesh, India
| | - Aneesh Srivastava
- Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar pradesh, India
| | - Uday Pratap Singh
- Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar pradesh, India
| | - Hira Lal
- Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Nakib G, Nesnas Z, Amoroso S, Calcaterra V, Pelizzo G. Laparoscopic nephrectomy in crossed fused kidney ectopia with severe hydronephrosis in 2 year-old child. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2020. [DOI: 10.1016/j.epsc.2019.101368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Loganathan AK, Bal HS. Crossed fused renal ectopia in children: a review of clinical profile, surgical challenges, and outcome. J Pediatr Urol 2019; 15:315-321. [PMID: 31331806 DOI: 10.1016/j.jpurol.2019.06.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 06/20/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Crossed fused renal ectopia is a rare congenital malformation, wherein both kidneys are present unilaterally, with the ureter of the crossed kidney opening into the bladder on the contralateral side. It has varied presentation from incidental detection to renal impairment. In this largest series of crossed fused renal ectopia, the authors assessed the clinical profile of these children and also attempted to shed light on the challenges in the surgical management. METHODS It is a retrospective study conducted from January 2009 to July 2018, among patients evaluated for crossed fused ectopia, in the Department of Pediatric Surgery, Christian Medical College, Vellore. Electronic medical records of 36 children were reviewed. Imaging modalities and operative interventions were recorded. Results were analyzed. RESULTS A total of 36 children were found to have crossed fused ectopia, with male preponderance. Most children presented within one year of age with urinary tract infection being the commonest cause. The most common associated anomaly was anorectal malformation. Ultrasound abdomen and pelvis, micturating cystourethrogram, and radionucleotide scans were the imaging modalities preferred for diagnosis and follow-up. Left-to-right ectopia was more common with inferior ectopic variant being the most common. The predominant urological problems include pelviureteric junction obstruction, vesicoureteric junction obstruction, and vescioureteric reflux. Ureteric re-implant was the most common surgery performed followed by pyeloplasty. Pelvi-pelvostomy, uretero-ureterostomy, bladder augment with Mitrofanoff, and other procedures were performed for select cases. CONCLUSION Crossed fused renal ectopia is a challenging entity which requires individualized management plans based on the predominant urological anomaly and the functional status. Surgical options are diverse and are guided toward the symptomatic urological problem with focus on preserving the renal function. The long-term prognosis is good in these children.
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Affiliation(s)
- A K Loganathan
- Department of Pediatric Surgery, Christian Medical College, Vellore, India
| | - H S Bal
- Department of Pediatric Surgery, Christian Medical College, Vellore, India.
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Jallouli W, Sellami A, Chaker K, Bibi M, Ben Chehida MA, Gargouri MM, Abid K, Ben Rhouma S, Nouira Y. About a case of ureteropelvic junction obstruction in L-shaped cross-fused kidney. Urol Case Rep 2018; 20:98-99. [PMID: 30105208 PMCID: PMC6077839 DOI: 10.1016/j.eucr.2018.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Revised: 07/25/2018] [Accepted: 07/26/2018] [Indexed: 10/31/2022] Open
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Saini S, Yadav S, Nayak B. Double trouble: pelvi-ureteric junction obstruction and renal cell carcinoma in right to left crossed fused ectopia. BMJ Case Rep 2016; 2016:bcr-2016-217496. [PMID: 27908908 DOI: 10.1136/bcr-2016-217496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Crossed renal ectopia is a rare occurrence. The majority of the crossed units are fused to their ipsilateral mate. Pelvi-ureteric junction obstruction (PUJO) in crossed fused moieties has been reported very rarely. Similarly, malignancy arising in the crossed over moieties is a rare occurrence too. Only a few cases have been reported earlier. We are here reporting an unusual case with coexistent PUJO and renal cell carcinoma in the crossed over moiety of right to left crossed fused ectopia. To the best of our knowledge, this is the first reported case with both these pathologies, coexisting, in the crossed over moiety. The patient underwent open radical nephrectomy of the right moiety via a lower midline incision. Surgery in this scenario is very challenging due to complex anatomy with aberrant vasculature, which needs for dissection within the renal parenchyma, similar to nephron-sparing surgery to separate from the normal moiety.
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Affiliation(s)
- Sumit Saini
- Department of Urology, All India Institute of Medical Sciences, New Delhi, India
| | - Siddharth Yadav
- Department of Urology, All India Institute of Medical Sciences, New Delhi, India
| | - Brusabhanu Nayak
- Department of Urology, All India Institute of Medical Sciences, New Delhi, India
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Agrawal S, Chipde SS, Kalathia J, Agrawal R. Renal stone in crossed fused renal ectopia and its laparoscopic management: Case report and review of literature. Urol Ann 2016; 8:236-8. [PMID: 27141201 PMCID: PMC4839248 DOI: 10.4103/0974-7796.176871] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Management of renal stone in crossed fused renal ectopia (CFRE) is difficult because of abnormal location, malrotation, and its relations with vertebral column and small bowel. Management is not standardized because of the paucity of literature and variable anatomy. We managed an 8-year-old boy with multiple renal stones in right side crossed kidney by laparoscopic pyelolithotomy and nephro pyeloscopy with the help of ureteroscope. Until now, there is only one prior report of laparoscopic pyelolithotomy in CFRE. We share our experience in this case and review the literature regarding the management of kidney stones in this rare anomaly.
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Affiliation(s)
- Santosh Agrawal
- Department of Urology and Renal Transplant, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Saurabh Sudhir Chipde
- Department of Urology and Renal Transplant, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Jaisukh Kalathia
- Department of Urology and Renal Transplant, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Rajeev Agrawal
- Department of Urology and Renal Transplant, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
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Muller CO, Blanc T, Peycelon M, El Ghoneimi A. Laparoscopic treatment of ureteropelvic junction obstruction in five pediatric cases of pelvic kidneys. J Pediatr Urol 2015; 11:353.e1-5. [PMID: 26233554 DOI: 10.1016/j.jpurol.2015.04.042] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 04/15/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Ectopic kidney is a rare urologic condition and may be revealed by ureteropelvic junction obstruction (UPJO) in children, with pelvic kidney being the most common location. Our experience using a minimally invasive approach to treat UPJO by dismembered pyeloplasty led us to report five cases of UPJO with pelvic kidney operated on by transperitoneal laparoscopy, focusing on medium-term follow-up results and surgical technique. PATIENTS AND METHODS From 1999 to 2010, we reviewed all cases of UPJO managed in our center, a total of 391 patients. Among those, 125 patients were operated on via a minimal invasive approach, 104 by retroperitoneoscopy, and 21 by transperitoneal laparoscopy. Five patients presented ectopic pelvic kidney and were retrospectively reviewed. US-scan and uro-MRI were done preoperatively in all cases for anatomic and functional evaluation. Peri-operative data such as operative time, transfusion, and complications were reported. At last clinic, sonographic and functional evaluation was noted. Focusing on surgical technique, we reported the tips and tricks to successfully and easily perform the dismembered pyeloplasty: optimization of the trocars' location according to the kidney location and use of a transparietal stay stitch to stabilize the suture line of the pyeloplasty. RESULTS All five patients underwent dismembered pyeloplasty, at a mean age of 8 years and a mean weight of 23.4 kg. Mean operative time was 213 min (min-max: 180-245). One case of giant hydronephrosis and megacalicosis required conversion at the beginning of the learning curve. None of the patients required blood transfusion. Mean hospital stay was 2.4 days (range: 1-4). All the patients had an uneventful postoperative recovery and good postoperative functional results, with either stable or improved pelvic dilatation and renal function at a mean follow-up of 3.3 years (range: 2-5.6). DISCUSSION This small series of five ectopic kidneys reflects the surgical challenge for the pediatric surgeon to perform reconstructive surgery on an abnormal anatomy. However, increasing experience in robotics in urologic pediatric surgery may lead to shortening of operative time and facilitate both dissection and suturing. CONCLUSION Dismembered pyeloplasty by transperitoneal laparoscopy is a feasible although technically demanding, safe and effective approach in the management of ureteropelvic junction obstruction in pelvic kidney in children.
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Affiliation(s)
- Cécile O Muller
- Department of Pediatric Surgery and Urology, Hôpital Robert Debré, APHP, Paris, France
| | - Thomas Blanc
- Department of Pediatric Surgery and Urology, Hôpital Necker, APHP, Paris, France
| | - Matthieu Peycelon
- Department of Pediatric Surgery and Urology, Hôpital Robert Debré, APHP, Paris, France
| | - Alaa El Ghoneimi
- Department of Pediatric Surgery and Urology, Hôpital Robert Debré, APHP, Paris, France.
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Skolarikos A, Dellis A, Knoll T. Ureteropelvic obstruction and renal stones: etiology and treatment. Urolithiasis 2015; 43:5-12. [PMID: 25362543 DOI: 10.1007/s00240-014-0736-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 10/23/2014] [Indexed: 12/20/2022]
Abstract
The simultaneous surgical management of ureteropelvic junction obstruction (UPJO) with concomitant renal stones has evolved the last 20 years; hence, the ideal minimally invasive technique is still controversial. Laparoscopic and robot-assisted laparoscopic operations allow precise surgical maneuvers and were thought to simplify the reconstruction steps of the procedure, especially in the treatment of complex cases with large stones. The aim of this study was to summarize the available perioperative and functional outcomes of minimally invasive available techniques. A non-systematic review of the literature was performed using a free-text protocol in the MEDLINE database. The terms used were "ureteropelvic junction obstruction," "renal calculi" and "renal stones." Furthermore, other significant relevant studies cited in the reference lists of the selected papers were also evaluated in the structure of this review. Currently, available evidence suggests that both laparoscopic and robotic-assisted techniques offer excellent surgical solutions in the field of UPJO reconstruction and renal stones removal. In the hands of experienced surgeons, laparoscopic and robotic pyeloplasty with concomitant stone removal is a safe procedure with high stone-free rates and UPJ patency. Minimally invasive pyeloplasty should constitute the first choice of treatment for concomitant renal stones and ureteropelvic junction obstruction.
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Affiliation(s)
- Andreas Skolarikos
- 2nd Department of Urology, Sismanoglio Hospital, Athens Medical School, Athens, Greece
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Muruganandham K, Kumar A, Kumar S. Laparoscopic pyeloplasty for ureteropelvic junction obstruction in crossed fused ectopic pelvic kidney. Korean J Urol 2014; 55:764-7. [PMID: 25405020 PMCID: PMC4231155 DOI: 10.4111/kju.2014.55.11.764] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Accepted: 08/16/2013] [Indexed: 11/29/2022] Open
Abstract
Crossed fused renal ectopia is a rare anomaly and may be associated with pelvic ureteric junction obstruction (PUJO). The L-shaped fusion variety is even rarer. We report such a case with a crossed fused ectopic pelvic kidney (L-type) with PUJO and its successful laparoscopic management. Through this report we emphasize the importance of adequate preoperative imaging and intraoperative details to avoid mishaps.
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Affiliation(s)
- Kalyaperumal Muruganandham
- Department of Urology, JIPMER (Jawaharlal Institute of Postgraduate Medical Education & Research), Puducherry, India
| | - Avijit Kumar
- Department of Urology, JIPMER (Jawaharlal Institute of Postgraduate Medical Education & Research), Puducherry, India
| | - Santosh Kumar
- Department of Urology, JIPMER (Jawaharlal Institute of Postgraduate Medical Education & Research), Puducherry, India
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Abstract
PURPOSE OF REVIEW While most renal and ureteral stones can be efficiently managed using endourologic techniques, the use of laparoscopy for the management of urolithiasis is increasing. The application of laparoscopy for stone removal will further reduce the need for open stone surgery. RECENT FINDINGS Laparoscopic ureterolithotomy, pyelolithotomy, and anatrophic nephrolithotomy are highly successful techniques with regard to their one-session, high stone-free rates. These procedures could be considered as the preferred approaches when endourologic procedures are not available or have failed. Laparoscopic stone surgery (LSS) in patients with urinary tract anomalies offers a reliable minimally invasive procedure as an alternative to a complex endourologic technique. SUMMARY Although laparoscopy still has a limited role in the urologist's armamentarium for the surgical management of urolithiasis, it can further reduce the need for open stone surgery in complex circumstances. LSS duplicates its open counterpart and offers a high one-session, stone-free rate in most patients with a lower morbidity and quicker convalescence. More comparative studies are needed to define the role and indications of LSS in relation to endourologic and open techniques, especially in complex circumstances.
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Abstract
Stones in abnormal situations present a management conundrum to the urologist. Many of these situations are relatively rare and literature is scanty on the appropriate management. We review the current literature on the management of stones in the setting of pregnancy, calyceal diverticulum, urinary diversions, pelvic kidneys, transplant kidneys, autosomal dominant polycystic kidney disease, horseshoe kidneys, and other renal anomalies. The aims of treatment are complete stone-free status. The modality of treatment should be individualized to the size and location of stone and type of abnormal situation confronted.
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Affiliation(s)
- Yung K Tan
- Department of Urology, Columbia University Medical Center, New York, NY 10032, USA
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Lee YS, Yu HS, Kim MU, Jang HS, Lee DH, Yeom CD, Hwang JH, Ham WS. Retroperitoneoscopic partial nephrectomy in a horseshoe kidney. Korean J Urol 2011; 52:795-7. [PMID: 22195272 PMCID: PMC3242996 DOI: 10.4111/kju.2011.52.11.795] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Accepted: 05/23/2011] [Indexed: 11/18/2022] Open
Abstract
A 21-year-old woman with a 4 cm enhancing cystic renal mass in the left moiety of a horseshoe kidney was treated through a retroperitoneal laparoscopic approach. The tumor was excised completely with cold scissors, and renal parenchyma suturing with a surgical bolster was done with Vicryl 2-0 sutures. Choosing the proper approach according to the location of the lesion and the surgeon's experience with both approaches are of importance in laparoscopic surgery in horseshoe kidney cases. A preoperative kidney computed tomography angiography was helpful for understanding the complex renal vasculature.
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Affiliation(s)
- Yong Seung Lee
- Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
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Abstract
PURPOSE OF REVIEW Despite increasing laparoscopic expertise in reconstructive surgery, open procedures still represent the gold standard. Robot-assisted techniques increasingly replace laparoscopy. However, laparoscopy is also developing: by improvement of ergonomics, new instruments, and techniques further reducing access trauma. We evaluated the actual role of laparoscopy focusing on main indications of urologic reconstructive surgery. RECENT FINDINGS We analysed the current literature (PubMed/Medline) concerning indications, perioperative results, complications, and long-term outcome of laparoscopy for pyeloplasty, ureteral reimplantation, stone surgery, management of vesico-vaginal fistula, sacrocolpopexy (including evidence level). For all indications, laparoscopy provides the advantages of less postoperative pain, blood loss, shorter convalescence, and minimal disfigurement. However, it requires expertise with endoscopic suturing. Most experience (N > 1000) exists with laparoscopic pyeloplasty and sacrocolpopexy which can be considered as valuable options (IIB). Concerning ureteral reimplantation and repair of vesico-vaginal fistula, only a limited number of cases were reported (N < 150) (III). Laparoscopic stone surgery may gain importance particularly in developing countries. Robot-assistance will definitively increase the application of laparoscopic techniques providing optimal ergonomics, whereas the role of single-port surgery will be limited. SUMMARY Laparoscopy will increasingly be used for reconstructive urologic surgery. This trend will be supported by the widespread use of the DaVinci device.
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Noble MJ. Editorial comment. Urology 2010; 76:252-3; author reply 253. [PMID: 20599123 DOI: 10.1016/j.urology.2009.09.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2009] [Revised: 09/28/2009] [Accepted: 09/29/2009] [Indexed: 11/19/2022]
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Micali S, Pini G, Sighinolfi MC, De Stefani S, Annino F, Bianchi G. Laparoscopic Simultaneous Treatment of Peripelvic Renal Cysts and Stones: Case Series. J Endourol 2009; 23:1851-6. [DOI: 10.1089/end.2009.0042] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Salvatore Micali
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Giovannalberto Pini
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Stefano De Stefani
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Filippo Annino
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Giampaolo Bianchi
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
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Hruza M, Schulze M, Teber D, Gözen AS, Rassweiler JJ. Laparoscopic Techniques for Removal of Renal and Ureteral Calculi. J Endourol 2009; 23:1713-8. [PMID: 19785553 DOI: 10.1089/end.2009.1539] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Marcel Hruza
- Department of Urology, SLK-Kliniken Heilbronn GmbH, Teaching Hospital of Heidelberg University, Heilbronn, Germany
| | - Michael Schulze
- Department of Urology, SLK-Kliniken Heilbronn GmbH, Teaching Hospital of Heidelberg University, Heilbronn, Germany
| | - Dogu Teber
- Department of Urology, SLK-Kliniken Heilbronn GmbH, Teaching Hospital of Heidelberg University, Heilbronn, Germany
| | - Ali Serdar Gözen
- Department of Urology, SLK-Kliniken Heilbronn GmbH, Teaching Hospital of Heidelberg University, Heilbronn, Germany
| | - Jens Jochen Rassweiler
- Department of Urology, SLK-Kliniken Heilbronn GmbH, Teaching Hospital of Heidelberg University, Heilbronn, Germany
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Laparoscopic Pyeloplasty with Concomitant Pyelolithotomy: Technique and Outcomes. J Endourol 2008; 22:1251-5. [DOI: 10.1089/end.2008.0003] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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Abstract
INTRODUCTION The increasing spread and technical enhancement of endourological methods has led to displacement of the surgical therapy of renal and ureteral calculi. MATERIALS AND METHODS Based on a review of current literature, we describe indications, technique, and clinical importance of the open and laparoscopic management of urolithiasis. RESULTS In Europe and North America, the surgical therapy of urolithiasis only plays a role in cases of very large or hard stones, after failure of shock wave lithotripsy, percutaneous nephrolithotripsy, or ureteroscopic stone removal, and in cases of abnormal renal anatomy, i.e., only in a few percent of all stone therapies. However, in developing countries and emerging markets with different structure and funding of the health care system where the methods of endourology are not readily available, these techniques still have a higher importance. Particularly in Europe, laparoscopic surgery is emerging because calculi can be removed from almost all locations in the kidney and ureter using a transperitoneal or retroperitoneal access. Functional outcomes and complication rates are comparable. The benefits of laparoscopy are less postoperative pain, shorter hospital stay, faster convalescence, and better cosmetic results. CONCLUSIONS Although procedures for open and laparoscopic removal of renal and ureteral calculi are only performed in rare cases in daily urological practice, they are superior to the endourological techniques in some circumstances. Therefore, they should still be part of the urologist's skills.
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Simone G, Leonardo C, Papalia R, Guaglianone S, Sacco R, Forastiere E, Gallucci M. Case report: laparoscopic ureteral reconstruction with pelvic flap in ureteropelvic junction obstruction of ectopic left kidney. J Endourol 2007; 21:1041-3. [PMID: 17941784 DOI: 10.1089/end.2006.0273] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A 33-year-old woman with ureteropelvic junction obstruction in an ectopic left kidney underwent laparoscopic pyeloplasty. Because of dense adhesions and a short ureter, we reduced the pelvis and created a tubularized pelvic flap using the Endo-GIA device to form a neoureter. No major complications were observed. A 6-month postoperative three-dimensional CT scan showed good renal function without hydronephrosis.
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Affiliation(s)
- Giuseppe Simone
- Department of Urology, Regina Elena Cancer Institute, Rome, Italy.
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Abstract
This article reviews the most common renal anomalies and the management of patients with calculus disease in anomalous kidneys. The emphasis is on minimally invasive techniques to achieve a stone-free status with minimal morbidity.
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Affiliation(s)
- Mantu Gupta
- Columbia University School of Medicine, College of Physicians & Surgeons, 11th Floor Department of Urology, 161 Fort Washington Avenue, New York, NY 10032, USA.
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