[Laparoscopic pyeloplasty for hydronephrosis of horseshoe kidney]

Horseshoe kidney is often associated with other congenital abnormalities and obstruction of pyeloureteral segment (PUS). The aim of our study was to evaluate the results of laparoscopic pyeloplasty (LP) in patients with hydronephrosis of horseshoe kidney.

From February 2010 to March 2016, 130 patients underwent LP. Ten (7.7%) of them (6 men and 4 women) had a hydronephrosis of horseshoe kidney. Left and right PUS obstruction were diagnosed in 6 and 4 patients, respectively. All the patients underwent PL transperitoneally using the Anderson-Hynes method. In patients with left hydronephrosis, surgery was performed by transmesenteric access.

There were no cases of conversion to open surgery and drainage urine leakage. Exacerbation of chronic pyelonephritis was observed in 2 cases. Operating time ranged from 125 to 160 minutes (median 130 minutes), time of performing pyeloureteral anastomosis - from 50 to 105 minutes. Patients were ambulated within the first day after surgery, the length of hospital stay was 3 - 4 days. One patient with recurrent strictures of PUS 8 months after the LP underwent retrograde endopyelotomy with the placement of endopyelotomy stent. The effectiveness of operations over a 6-38 month follow-up was 90%.

LP is an effective and minimally invasive treatment for patients with hydronephrosis of horseshoe kidney. In a left PUS obstruction, pyeloplasty can be performed using transmesenteric access.