[New surgery for complicated renal anomalies]

The indications for "ex vivo" surgery and autotransplantation have been broadened o complicated renal anomalies; particularly in the cases of the horseshoe kikney and kidney malrotation. This position is justified as conventional techniques do not correct the multiple causes that are responsible for these complications. These complications requiere a surgical strategy that simultaneously deals with the pathology of the renal anomaly itself and that of its excretory tract. The aforementioned means that the abnormal kidney orientation and position must be retified to permit a large resectioning of the dysplasic or dystrophic excretory conduct in order to achieve normal urinary drainage while conserving all the renal parenchyma. It has been achieved in thirteen out of the 14 cases operated on that correspond to distinct types of complicated anomalies. The excellent results demonstrate that this new and innovative surgery has resolved the complex and difficult issue of kidney malformations. The surgical method and long-therm results in the adult and child, the first in the literature, are presented here.