SCHEVELYOV T. Diagnostics and Surgical Treatment of Hydronephrosis of Horseshoe Kidney in Children.

The dissertation is devoted to elaboration of pathogenetic substantiation and analysis of clinical efficacy of new methods of diagnostics and surgical treatment of hydronephrosis of horseshoe kidney in children. Hydronephrosis of horseshoe kidney was found in 21 patients among 60 children with horseshoe kidney (35%) being at the departments of Pediatric Surgery and Urology during the period of 1988-2001 (28 renal units). More frequently the hydronephrosis of horseshoe kidney was found at the age from 7 to 15 (62,0%) that says about a late diagnostics. There were 8 boys and 13 girls there.Unilateral lesion was in 14 patients, bilateral - in 7. Hydronephrosis of horseshoe kidney of the 1 degree was found in 4 children, the 2 degree - in 3, the 3 degree - in 13, the 4 degree - in 3 children. Such causes of hydronephrotic transformation were found in children with hydronephrosis of horseshoe kidney: high insertion of ureter - 19 renal units (67,9%), stenosis of pelviureteric junction - 8 renal units (28,6%), aberrant vessel - 1 renal unit (3,5%). For renal unit we take a half of a horseshoe kidney.In the complex of diagnostic search at the hydronephrosis of horseshoe kidney we use exept of radiologic and angiographic methods diagnostic ultrasound of horseshoe kidney according to our special method and computer-based renangiography.The special method of diagnostic ultrasound of horseshoe kidney and the diagnostic system of this anomaly with using of some diagnostic signs (8) are worked out. The research took place in 2 stages: the 1 stage - the working out of ultrasonic diagnostic signs of horseshoe kidney were defined during the investigation of 20 patients with horseshoe kidney at the age of 5 - 15 years old. During the 2 stage of the research diagnostic ultrasound of kidneys and bladder took place with 1190 patients of the urological department, 42 patients of this group had these signs in the sum of 6 and more marks. The determination of the diagnostic sign from one side is taken over 0,5 mark and from bothsides - 1,0 mark. The horseshoe kidney is diagnosed by the sum of 6 and more marks. During the 1 and the 2 stages of the research the signs