The double kidney in children. The clinical and morphopathological aspects

Abstract

The study included a batch of 86 children from 3 months to 3 years age with double kidney diagnostics treated in pediatric urology departments during the years 2006-2016. From the 86 patients - 42 were diagnosed with double kidney and obstructive megaureterohydronephrosis of superior pelvic; 34 - with double kidneys with refluxing megaureterohydronephrosis of superior pelvis and 12 - with nonfunctional kidneys. The surgeries were performed: 1. The Lumbotomia. The heminefrectomy of upper renal pelvis. The capsulotomy of the resting kidney segment (17 cases); 2. The Lumbotomia. The heminefrectomy of upper renal pelvis. The capsulotomy of the rest of the kidney segment. The second approach - survezical ureterectomy of the residual stump (11 cases); 3. The Gregoire’s plastic joint antireflux surgery in a common block (34 cases); 4. The resection of the lower ureter segment of the renal pyelone with ureterocystoneanastomosis, the procedure by Mö-bly (4 cases) 5. The lumbotomia. The nephroureterectomy of both kidneys. The supravezical ureterectomy of both ureteral stumps (12 cases); 6. The Ureteral resection with ureter neoimplantation, the procedure by Mö-bly (10 cases). The morphological explorations were performed intraoperatively and postoperatively with retrospective examinations based on the material (renal and ureteral complexes, kidneys, kidney and ureter segments), removed in surgical interventions and biopsy of the renal pelvis at distance by applying macroscopy (organometry, macrometry) and microscopy of tissue specimens. The histological processing methods included the method by cryotomy and the usual histochemical method. The methods of coloring with hematoxylin-eosin, picrofuxin by Van Gieson, Arnold’s silvering method after Bilshovski-Grosse were used. The results of morphopathological investigations have allowed us to establish the mechanisms of lesions at the cell, tissue, organ level, which require new solutions in the choice of effective diagnostic methods and the level of surgical interventions, which is of decisive importance in the choice of surgical management.