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요관류 혹은 이소성 요관을 동반한 완전 중복요관 환아에서의 일차적 치료: 요관신우문합술

Other Titles
 First-line Treatment Modality in Children with Complete Duplicating System Complicated with Ureterocele or Ectopic Ureter: Ureteropyelostomy 
 최호성  ;  진옥현  ;  한상원 
 KOREAN JOURNAL OF UROLOGY, Vol.43(8) : 667-671, 2002 
Journal Title
Issue Date
Duplicated collecting system ; Ectopic ureter ; Ureterocele ; Ureteropyelostomy
Purpose: A complete duplicated collecting system complicated with an ectopic ureter or ureterocele results in renal damage due to a ureteral obstruction or reflux. The clinical outcome of ureteropyelostomy in complicated complete duplicated collecting system was evaluated. Materials and Methods: 20 children received a ureteropyelostomy for either an ectopic ureter or ureterocele with a complete duplicated collecting system anomaly. The median age was 3.2 months. Of the children, 11 had ureteroceles including 7 cecoureteroceles, and 9 had ectopic ureters. The associated anomalies were 3 UPJ obstructions of the lower pole and 9 VUR. All received a ureteropyelostomy. The lower pole ureter was used as the common ureter except in 2 cases with a lower ureter in poor condition. A lower pole pyeloplasty was combined in 3 cases with UPJ obstructions of the lower pole. A distal ureteral stump was left open except in the cecoureterocele in order to prevent VUR. Their clinical courses were followed up with an ultrasonogram and 99mTc-DMSA scan. The median follow-up after surgery was 17.8 months. Results: A reduced upper pole hydronephrosis was observed in 19 patients and an improvement in the differential renal function was noted in 17 patients on the follow-up studies. All ureteroceles had either disappeared or were reduced in size. 7 patients showed an intermittent asymptomatic bacteriuria and 1 patient showed symptomatic UTI who required an ureteroneocystostomy during the follow-up. Conclusions: A ureteropyelostomy is recommended as a first-line treatment modality for patients with a complicated complete duplicated collecting system owing to the lower chance of secondary surgery, the prevention of deterioration in the bladder function and the possibility of early correction.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Han, Sang Won(한상원) ORCID logo https://orcid.org/0000-0003-0941-1300
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