Jurnalul de Chirurgie
 Jurnalul de chirurgie
Aparitie trimestriala in a doua luna a trimestrului
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ISSN: 1584 - 9341 Vol.10 Nr.3 - Iulie-Septembrie 2014 | miercuri, 16 octombrie 2019
ISSN: 1584 - 9341 Vol.10 No.3 - July-September 2014
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CROSSING VESSELS IN THE URETEROPELVIC JUNCTION OBSTRUCTION: ROLE OF THE IMAGING METHODS IN SURGICAL TREATMENT PLANNING 
C. Novac, C. Ciută, B. Novac, L. Todosi, I. Tomac, Veronica Tănasă
Clinica de Urologie şi Transplant Renal
Spitalul Clinic „C.I. Parhon” Iaşi
Universitatea de Medicină şi Farmacie „Gr.T. Popa“ Iaşi
Jurnalul de chirurgie 2007; 3 (2):148-152
Full text: PDF Format (Romana/Romanian)

Abstract:

BACKGROUND:
The knowledge of  asssociation of the crossing vessels in the ureteropelvic junction obstruction is important in planning the therapeutic strategy (endoscopic procedure, laparoscopic or open pyeloplasty). Next to the well-known imaging methods (ultrasonography-US, intravenous urography-IVU and retrograde pyelography-RP) is added the Doppler colour ultrasonography (US) which in the hands of a well-trained uroradiologist is reliable enough in the preoperative diagnosis of the vessels crossing at the ureteropelvic junction. But there is a controversy regarding the functional significance of this vessels in the ureteropelvic obstruction, because the information brought by Doppler colour US relyes on topographical data. Crossing vessels are important for two reasons: they are a potential source of hemorrhage following endoscopic incision and they may play an etiologic role in ureteropelvic junction obstruction and therefore may be a reason for failure of endoscopic techniques.

OBJECTIVE: This article reviews the reliability of the imaging methods, especially colour Doppler US, in the detection of crossing vessels in patients with surgically proven ureteropielic junction obstruction.

METHODS: The files of all 117 patients who were diagnosed with ureteropelvic junction obstruction in our clinic between 2002 and 2005 were reviewed. There were selected and analysed the cases of 21 patients surgically treated and intra-operative diagnosed with crossing vessels. The indication for surgery was according to the usual criteria.

RESULTS: Usual imaging methods (US, IVU) were used in all cases, and RP only in 9 selected cases. The results cleared up the three goals of imaging for ureteropelvic junction obstruction: to determine the presence and degree of renal obstruction, to assess renal function, and to determine the cause of the problem. For this final objective, Doppler colour US proved to have a sensibility of 79,6% in detecting the crossing vessels.

CONCLUSION: Colour Doppler US is reliable in the detection of crossing vessels at the ureteropelvic junction guiding the strategy to open dismembered pyeloplasty.


KEYWORDS: URETEROPELVIC JUNCTION, CROSSING VESSELS, COLOUR DOPPLER, PYELOPLASTY

Corespondenţă: Dr. Ciută Cătălin, Clinica de Urologie şi Transplant Renal, Spitalul Clinic „C.I. Parhon” Iaşi, Bd. Carol I, Nr. 50, 700503, Iaşi; e-mail:



: Creative Commons License
Jurnalul de chirurgie [Journal of Surgery] by Editorial Board, Department of Surgery University of Medicine and Pharmacy Iasi, E. Tarcoveanu, R. Moldovanu is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.
Based on a work at www.jurnaluldechirurgie.ro.