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Colocalicostomy. A solution to an obliterated renal pelvis
1Department of Urology, Long Island Jewish Medical Center, New Hyde Park, New York.
Urology
|February 1, 1990
Summary
Urinary tract reconstruction for a paraplegic patient involved novel surgical techniques. Anatrophic nephrotomy and colonic or jejunal interposition achieved effective internal drainage for complex ureteral strictures.
Area of Science:
- Urology
- Surgical Innovation
Background:
- Complex urinary tract reconstruction is challenging in patients with ileal conduit urinary diversion and bilateral ureteral strictures.
- Existing techniques were insufficient for this patient's specific anatomical challenges.
Observation:
- A 39-year-old paraplegic patient presented with long bilateral ureteral strictures and an ileal conduit.
- The patient required a reconstructive procedure to ensure effective internal urinary drainage.
Findings:
- Anatrophic nephrotomy was performed on the right kidney, anastomosing it to a transverse colon segment.
- The left kidney was anastomosed end-to-side to an isolated jejunal segment due to direct colonic anastomosis infeasibility.
- This dual-technique approach successfully established internal drainage.
Implications:
- Colocalicostomy is a viable option for reconstructing obliterated renal pelves or isolated, obstructed calices.
- This case highlights the adaptability of surgical techniques in complex urological reconstructions.
- Novel anastomotic strategies can overcome limitations in urinary tract reconstruction.