Ureterocalicostomy for reconstruction of complicated ureteropelvic junction obstruction.
OBJECTIVE
To review our experience with ureterocalicostomy using the treatment of complicated ureteropelvic junction (UPJ) obstruction.


METHODS
Medical records of all patients with complicated ureteropelvic junction obstruction treated by ureterocalicostomy from 1985 to 2000 were reviewed. Causes of UPJ obstruction, surgical techniques, peri-operative course and outcome were noted.


RESULTS
Fifteen patients were enrolled in this study (6 males and 9 females) with the mean age of 39 years old (28-45). Twelve patients were after stone surgery, 2 were after pyeloplasty for congenital UPJ obstruction and one patient was after blunt abdominal trauma. All the procedures were done by flank incision. After excision of the lower pole, the ureter was anastomosed to the lower caliceal mucosa without tension over an internal stent. Nephrostomy tubes were used in all of the patients. The mean hospital stay was 14 days (10-20). Twelve cases (80%) were found to be successful and are still doing well with the mean follow-up time of 2.5 years (0.5-12). Three patients (20%) were found to have failed, and subsequently nephrectomy was done in one case and permanent nephrostomy was used in 2 cases due to a solitary kidney.


CONCLUSIONS
Ureterocalicostomy is one of the options for treatment of complicated UPJ obstruction that can provide good drainage as well as excellent long term results.
Kochakarn
Wachira
W
Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Viseshsindh
Vira
V
Muangman
Verasing
V
D000328:Adult; D000714:Anastomosis, Surgical; D005260:Female; D006801:Humans; D007670:Kidney Calices / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014513:Ureter / Q000601:surgery*; D014517:Ureteral Obstruction / Q000601:surgery*; D013520:Urologic Surgical Procedures