First experience of laparoscopic heminephroureterectomy in patients with incomplete doubling of the urinary tract

Kochkin A.D., Sevryukov F.A., Abramov D.V.

The doubling of the upper urinary tract is fairly common congenital malformation, and in 14.6% of cases ureterohydronephrosis develops in one half of the kidney. It leads to the development of chronic urinary tract infections and pain. The only treatment option is surgery. Heminephroureterectomy traditionally performed from a wide traumatic lumbotomy access. One of the most topical issues of Urology is the development of minimally invasive surgical techniques. Thus laparoscopic radical nephrectomy has been recommended by the European Association of Urology as a standard treatment for kidney cancer. Laparoscopic heminephroureterectomy (LapHNE) is not a widely spread surgical intervention. Pediatric urologists are most experienced with such kind of surgeries. No publications about laparoscopic heminephroureterectomy in adult patients with incomplete doubling of the urinary tract were found. This prompted us to share with first experience of this intervention. The clinical case of successful surgical treament of patient with incomplete doubling of the left upper urinary tract, complicated with terminal hydronephrosis was presented. Medical history, clinical manifestation, laparoscopic technique of heminephroureterectomy, as well as short-and long-term outcomes were reported. We concluded that LapHNE has all advantages of laparoscopic approach like atraumaticity, minimum number of wound complications and rapid rehabilitation of patients.

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