Introduction. Obstruction of the pyeloureteral junction (PUJO) of the horseshoe kidney is a very rare disease both in adults and children. This is the reason for the small number of scientific works on the subject of pyeloplasty for this pathology in children. Isthmus crossing and nephropexy followed by dissecting pyeloplasty have been suggested as one of the surgical treatment options. There are no convincing data on the feasibility of this procedure in the literature.
The aim of our work was to evaluate 25 years of experience in the treatment of PUJO of horseshoe kidney in children.
Materials and Metods. A few small cohort studies have reported the efficacy of pyeloplasty for horseshoe kidney in children, and a limited number of studies have compared different operative treatments. It was these facts that prompted us to perform this work. We retrospectively evaluated the results of 112 pyeloplasties in 105 children from 1999 to 2024. Patients were divided into 3 groups according to the method of surgical intervention: open pyeloplasty with isthmotomy, open pyeloplasty without isthmotomy, laparoscopic pyeloplasty. We also divided the patients into 4 groups according to the method of urinary tract drainage.
Resulrs. Clinical data and outcomes were further analyzed. We obtained positive results when performing pyeloplasty in 92.9% of patients. There was no significant difference in pyeloplasty results between the groups. We also found no statistically significant differences in the methods of urinary tract drainage.
Conclusion. Today, preference should be given to minimally invasive method of treatment in children, even in such a complex malformation as hydronephrotic transformation of the horseshoe kidney, taking into account comparable results with the open method of treatment and the unconditional advantages of laparoscopic access in the form of early rehabilitation of the child, minimal pain syndrome and cosmeticity of this method.
