Phẫu thuật nội soi xuyên phúc mạc điều trị thận ứ nước do niệu quản sau tĩnh mạch chủ ở trẻ em

Retrocaval ureter, also known as circumcaval ureter, is a rare congenital anomaly where the ureter passes posterior to the inferior vena cava, leading to varying degrees of hydronephrosis due to compression. While historically managed with open surgery, advancements in minimally invasive techniques have reshaped its treatment landscape. Given its rarity, particularly in pediatric populations, consensus on optimal surgical approaches remains limited. This study aims to evaluate the safety and feasibility of transperitoneal laparoscopic pyeloplasty as a contemporary treatment for retrocaval ureter in children, contributing valuable insights into managing this complex congenital condition.

Pediatric surgeons, urologists, and medical researchers specializing in congenital genitourinary anomalies and minimally invasive surgical techniques in children.

Retrocaval ureter (NQSTMC), a rare congenital anomaly characterized by the ureter's anomalous course posterior to the inferior vena cava, frequently results in hydronephrosis. This retrospective study investigates the application and outcomes of transperitoneal laparoscopic pyeloplasty for treating this condition in children. The study analyzed cases of children diagnosed with NQSTMC and hydronephrosis who underwent this procedure at Children's Hospital 2 between January 2022 and December 2022. The research specifically reports on two cases where retrocaval ureter was incidentally discovered during investigations for intermittent right renal colic, both successfully treated with transperitoneal laparoscopic pyeloplasty. The findings demonstrate that this minimally invasive technique is both safe and feasible for addressing retrocaval ureter in pediatric patients, offering an alternative to traditional open surgery. While there is no current surgical gold standard for NQSTMC, and laparoscopic studies remain limited due to the condition's rarity, transperitoneal laparoscopic pyeloplasty proves to be an effective method. The discussion further highlights diagnostic methods like IVU and CT, and contrasts transperitoneal and retroperitoneal laparoscopic approaches, noting the preference for the transperitoneal route due to a larger working space and better visualization. This approach not only alleviates symptoms but also preserves renal function, making it the preferred treatment strategy at the authors' institution. The study underscores the importance of continued research to refine surgical protocols for this uncommon anomaly.