ureteropelvic anastomosis

Abnormal blood vessels of the congenital subrenal pole often cause obstruction of the ureteropelvic junction at the posterior ureter. Such abnormal blood vessels are quite common, and the movements and veins are often parallel. The artery is larger, and the nutrient of the renal parenchyma corresponding to the lower part of the kidney is supplied. Once severed, it can cause atrophy of the renal parenchyma in this area, and even secondary renal hypertension. If the abnormal blood vessels of the kidney are cut off and the subrenal pole is removed, it is not wise, and it is quite suspected of "squatting and pond fish". Treatment of diseases: ureteropelvic junction obstruction Indication Renal ureteropelvic anastomosis is suitable for: Such as abnormal blood vessels caused by obstruction of the fistula connection and other obstructive lesions in the wall and cavity, such as muscle fiber dysplasia, long-term vascular compression caused by ureteral stenosis, or the presence of wrinkles or valves in the cavity, when free blood vessels After the junction of the fistula and the fistula, the renal pelvis can not be empty, the lumen can not be filled and expanded in time, and the narrow ureteral segment is slender and tough. When obstructing the peristaltic wave conduction of the ureter, the ureter and ureter re-anastomosis should be performed. Although some patients have no vascular obstruction, but there are similar organic lesions in the fistula connection, it is not suitable for other angioplasty. It is also a surgical indication for ureteropelvic anastomosis. The technical operation of this operation is relatively simple and the effect is better. Surgical procedure The exposure of the operating area is the same as before. After the exploration was confirmed, the ureter was cut transversely at the lower end of the stenosis. A narrow ureter was cut for a section of the disease and the stump was ligated. The distal end of the ureter is cut into a cuff-like shape, which is divided into a petal shape and placed behind the abnormal blood vessel. An elliptical incision was made at the lowest position of the renal pelvis, and a ureteral stent tube and a renal pelvic drainage tube were placed through the renal parenchyma. The ureter and the renal pelvis are flap-shaped. It is advisable for the suture to be sutured with a 4-0 absorbable line. The rubber tube was placed around the renal pelvis and the anastomosis. The stent tube and the renal pelvis drainage tube were respectively fixed by absorbable lines. The layers of the incision were layered and sutured. The drainage material, the stent tube and the drainage tube were sutured to the skin to prevent slippage.