Giant hydronephrosis management in the Era of minimally invasive surgery: A case series
| Autor: | Hossam S. El-Tholoth, Tarek Alzahrani, Hamad Alakrash, Abdullah Waleed Aldughiman, Abdulrahman Alsunbul, Ahmed Alzahrani, Abdulrahman Binjawhar |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
musculoskeletal diseases
medicine.medical_specialty Decompression medicine.medical_treatment GH giant hydronephrosis Nephrectomy 03 medical and health sciences 0302 clinical medicine Giant hydronephrosis medicine Case Series Laparoscopy Nephrostomy Kidney medicine.diagnostic_test business.industry UPJO ureteropelvic junction obstruction Surgery medicine.anatomical_structure 030220 oncology & carcinogenesis Radiological weapon 030211 gastroenterology & hepatology Presentation (obstetrics) business |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| DOI: | 10.1016/j.ijscr.2020.09.144 |
| Popis: | Highlights • We reported on the laparoscopic trans-peritoneal approach for giant hydronephrosis. • No major peri-operative complications were reported. • Pre-operative decompression using a nephrostomy tube facilitates the surgery. Introduction Giant hydronephrosis (GH) is a rare urological entity, described as more than 1 L of fluid contained in the renal collecting system. Ureteropelvic junction obstruction (UPJO) is the most common cause. GH if not discovered and managed early can result in long term complications. We present our experience in the late presentation of adult Giant hydornephrosis. Presentation of cases We reviewed all the cases of patients with giant hydronephrosis who presented to our institute from December 2017–December 2019 at our institute. Pre-operative renal ultrasound, computed tomography with contrast and MAG-3 were performed on all patients to establish their diagnoses. The patients' demographic data, clinical presentation, preparatory investigations, indications for intervention, type of intervention, pre- and post-operative complications and durations of hospital stay were reported. Laparoscopic transperitoneal nephrectomy was completed in three cases without open conversion. One case proceeded to open conversion owing to a lack of space and severe adhesions. The mean operating time was 79.7 min (range: 65–95 min), estimated blood loss was 75 mL and the mean hospital stay was 4 days (range: 2–6 days). Discussion The first case of GH was described in 1746. Since then, few cases have been described in the literature. A radiological definition, is the occupation of the hemi-abdomen by the kidney with a midline cross which is the height of five vertebral bodies. GH may be congenital or acquired. The most common presentation of GH is abdominal distention followed by fever and flank pain. Conclusion When nephrectomy is indicated in giant hydronephrosis, the laparoscopic trans-peritoneal approach is feasible. Pre-operative decompression using a nephrostomy tube and suspension stitch use facilitate the surgery. |
| Databáze: | OpenAIRE |
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