URETEROCALICOSTOMY FOR RECONSTRUCTION OF THE UPPER URINARY TRACT.

The paper provides a retrospective study of long-term results of ureterocalicostomy (UC) performed in one specialized center. The study included 37 patients who underwent UC as a primary (43.2%) or secondary (56.8%) operation for intrarenal hydronephrosis or urolithiasis. All surgical interventions were classified into two groups according to the type of kidney resection: Type I - if the kidney parenchyma was more than 10 mm, the entire lower pole of the kidney was removed (72.9%); Type II - if the parenchyma was less than 10 mm, a part of the lower pole (1.5-2.0 cm) was removed in the zone of maximal parenchymal thinning (24.3%). All resections, depending on the angle of their plane, were also divided into transverse (48.6%) and oblique (51.4%). Early postoperative complications were observed in 14 (37.8%) patients. All complications were not severe and were classified as Grade I-II according to the Clavien-Dindo system. The univariate analysis showed that the predictors of UC complications are the long duration of the operation, warm renal ischemia for more than 20 minutes, the secondary nature of the operation, as well as the presence of acute pyelonephritis and urinary extravasation before the operation. The rate of good long-term results was 81.1% (n=30), satisfactory - 13.5% (n=5), poor - 5.4% (n=2). The reliable prognostic value in terms of negative surgery results had: the thickness of the renal parenchyma below 10 mm, as well as the use of Type II resection of the renal parenchyma. Conclusion. A high level of good UC results was demonstrated. The most important predictor was the renal parenchyma thickness less than 10 mm.