CLINICAL CASE OF LAPAROSCOPIC PYELOPLASTY FOR HYDRONEPHROSIS OF THE HORSESHOE KIDNEY IN A 3-YEAR-OLD BOY

Authors describe a clinical case of a combination of a horseshoe kidney and hydronephrosis of its left half in a 3-year-old male patient and laparoscopic pyeloplasty of the identified pathology. Based on the results of preoperative CT, the diagnosis was confirmed and obstruction of the pyeloureteral segment was found as a source of hydronephrosis. Laparoscopic surgery made it possible to clarify the anatomy of the horseshoe kidney and the reason for the pyeloureteral segment obstruction in the form of a high discharge of the ureter from the pelvis. The Anderson-Hynes pyeloplasty with pelvic stenting was performed. The duration of the surgical intervention was 70 minutes. The need for analgesia persisted for 1 day (paracetamol 15 mg/kg/8 h). The drainage tube was removed after a follow-up ultrasound examination on the 3^rdday, after which the patient was discharged for outpatient follow-up. The duration of follow-up was 6 months. The patient was asymptomatic throughout the control period. Repeated ultrasound performed 6 months after the surgical intervention revealed a decrease in the anteroposterior diameter of the pelvis to 8 mm. Conclusion: laparoscopic pyeloplasty is a feasible and safe procedure in patients with complex renal anatomy accompanied by the pyeloureteral segment obstruction. Accurate preoperative planning and standardized technique are the keys to successful treatment.