腎盂尿管移行部狭窄と臍動脈索による中部尿管狭窄の2カ所に対し，一期的な腹腔鏡手術を行った1例

Abstract

The patient first presented with left flank pain at the age of 15. Computed tomography (CT) and ultrasonography performed at that time revealed left hydronephrosis and hydroureter. Mid-ureteral obstruction was suspected, and he underwent balloon catheter dilation of the mid-ureteral obstruction. Hydronephrosis, hydroureter and flank pain improved after surgery. However, at 21 years of age, he again presented with left flank pain. CT and ultrasonography revealed pelvi-ureteric junction obstruction and mid-ureteral obstruction. The suspected cause of the mid-ureteral obstruction was the umbilical ligament. Renal scintigraphy showed an obstructive pattern in the left kidney, with 52% split renal function. He thus underwent laparoscopic pyeloplasty and end-to-end anastomosis of the mid-ureter with the one-step approach. No intra- or postoperative complications occurred, and the D-J stent was removed 6 weeks after surgery. At 12 months after surgery, he has had no recurrent flank pain and left renal function is normal.