Retroperitoneoscopic heminephrectomy of the right upper collecting system emptying into an ectopic ureterocele in a 5-year-old girl: a case report

Abstract

5歳女児.1歳2ヵ月より尿路感染症を繰り返し, 右異所性尿管瘤と診断され保存的に経過観察されていた.IVP, DMSA腎シンチで瘤所属右上半腎は無機能で下半腎に国際分類III度の膀胱尿管逆流症を認めた.1998年8月13日, 右後腹膜鏡下半腎摘出術及び瘤切除, 右下半腎逆流防止術を施行した.術後経過は良好で, 術後3ヵ月目のVCGでも逆流は消失し, 腎機能も良好であった.小児における腹腔鏡下半腎摘出術は現在迄に15例の報告があるが, 後腹膜アプローチは本症例が初めてである

A 5-year-old girl with a history of recurrent urinary tract infection since the age of 14 months was diagnosed as having a right duplicated urinary collecting system with the upper ureter ectopically opening in the urethra. She underwent retroperitoneoscopic heminephrectomy for a right dysplastic kidney and open ureterocelectomy and reimplantation of the refluxing lower ureter via Pfannenstiel incision. She survived the procedure without serious complications and resumed normal daily activities by day 6. To the best of our knowledge, this case is the 16th case of laparoscopic heminephrectomy for pediatric patients and the first case treated by the retroperitoneal approach in the English literature.