Robot-assisted transposition of aberrant lower polar renal vessels in a 14-year-old child with vasorenal hydrophnerosis

Abstract

This study presents a patient with pyeloureteral segment obstruction caused by aberrant inferior polar vessels using the robotic Hellström – Chapman procedure and reports its short-term results. A 14-year-old girl was admitted to Irkutsk Regional Children’s Clinical Hospital because of obstruction of the pyeloureteral junction caused by external compression by aberrant lower polar vessels. The diagnosis was established by ultrasonography and Doppler sonography and confirmed by contrasted computed tomography. Surgery was performed using the Versius surgical robot manufactured by CMR (UK). Delicate actions were used to mobilize the abnormal vessels and move them to the anterior wall of the pelvis. Then, they were “wrapped” with the anterior wall of the pelvis. Postoperative follow-up included clinical evaluation and renal ultrasound examination 1, 3, and 6 months after surgery. The operative duration was 65 min. During the robot-assisted Hellström – Chapman operation, no intraoperative complications, such as damage to the vessels supplying the kidney and neighboring organs, were noted. The patient did not require internal or external drainage of the upper urinary tract or perinephric space. The anteroposterior diameter of the pelvis decreased from 30 to 8 mm. The resistive index of the blood flow in the renal vessels decreased from 0.74 to 0.58. The Hellström – Chapman robotic procedure is a safe and effective procedure for the correction of vasorenal hydronephrosis. However, this surgery requires patient selection to ensure future treatment success.

Keywords

pyeloureteral junction obstruction / hydronephrosis / robot-assisted surgery / children / case report

References

[1] Wein AJ. Anomalies and surgery of the ureteropelvic junction in children. In: Carr MC, El-Ghoneimi A, editors. Campbell-Walsh urology. Philadelphia, PA: W.B. Saunders, 2007.

[2] Wein A.J. Anomalies and surgery of the ureteropelvic junction in children. In: Carr M.C., El-Ghoneimi A., editors. Campbell-Walsh urology. Philadelphia, PA: W.B. Saunders, 2007.

[3] Wein AJ. Anomalies and surgery of the ureteropelvic junction in children. In: Carr MC, El-Ghoneimi A, editors. Campbell-Walsh urology. Philadelphia, PA: W.B. Saunders, 2007.

[4] Panek W, De Jong TPVM, Szydełko T, Chrzan R. Management of crossing vessels in children and adults: A multi-center experience with the transperitoneal laparoscopic approach. Adv Clin Exp Med. 2019;28(6):777–782. DOI: 10.17219/acem/94142

[5] Panek W., De Jong T.P.V.M., Szydełko T., Chrzan R. Management of crossing vessels in children and adults: A multi-center experience with the transperitoneal laparoscopic approach // Adv Clin Exp Med. 2019. Vol. 28, No. 6. P. 777–782. DOI: 10.17219/acem/94142

[6] Panek W, De Jong TPVM, Szydełko T, Chrzan R. Management of crossing vessels in children and adults: A multi-center experience with the transperitoneal laparoscopic approach. Adv Clin Exp Med. 2019;28(6):777–782. DOI: 10.17219/acem/94142

[7] Anderson JC, Hynes W. Retrocaval ureter; a case diagnosed preoperatively and treated successfully by a plastic operation. Br J Urol. 1949;21(3):209–214. DOI: 10.1111/j.1464-410x.1949.tb10773.x

[8] Anderson J.C., Hynes W. Retrocaval ureter: a case diagnosed preoperatively and treated successfully by a plastic operation // Br J Urol. 1949. Vol. 21, No. 3. P. 209–214. DOI: 10.1111/j.1464-410x.1949.tb10773.x

[9] Anderson JC, Hynes W. Retrocaval ureter; a case diagnosed preoperatively and treated successfully by a plastic operation. Br J Urol. 1949;21(3):209–214. DOI: 10.1111/j.1464-410x.1949.tb10773.x

[10] Kagantsov IM, Minin AE, Sannikov IA. Laparoscopic pyeloplasty — modern standard of treatment of congenital hydrofnerosis in children. Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2012;(2):15–20.

[11] Каганцов И.М., Минин А.Е., Санников И.А. Лапароскопическая пиелопластика — современный стандарт лечения врожденного гидрофнероза у детей // Российский вестник детской хирургии, анестезиологии и реаниматологии. 2012. № 2. С. 15–20.

[12] Kagantsov IM, Minin AE, Sannikov IA. Laparoscopic pyeloplasty — modern standard of treatment of congenital hydrofnerosis in children. Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2012;(2):15–20.

[13] Vrublevsky SG, Gurevich AI, Vrublevskaya EN, et al. Endosurgical pyeloplasty in children as evolution of the “golden standard”. Russian Journal of Pediatric Surgery. 2013;(6):4–6.

[14] Врублевский C.Г., Гуревич А.И., Врублевская Е.Н., и др. Эндохирургическая пиелопластика у детей как эволюция золотого стандарта // Детская хирургия. 2013. № 6. С. 4–6.

[15] Vrublevsky SG, Gurevich AI, Vrublevskaya EN, et al. Endosurgical pyeloplasty in children as evolution of the “golden standard”. Russian Journal of Pediatric Surgery. 2013;(6):4–6.

[16] Bondarenko SG, Abramov GG. Laparoscopic pyelopasty in breast-fed infants. Russian Journal of Pediatric Surgery. 2013;(6):7–10.

[17] Бондаренко С.Г., Абрамов Г.Г. Лапароскопическая пиелопластика у детей // Детская хирургия. 2013. № 6. С. 7–10.

[18] Bondarenko SG, Abramov GG. Laparoscopic pyelopasty in breast-fed infants. Russian Journal of Pediatric Surgery. 2013;(6):7–10.

[19] Chandrasekharam VVS, Babu R. A systematic review and meta-analysis of conventional laparoscopic versus robot-assisted laparoscopic pyeloplasty in infants. J Pediatr Urol. 2021;17(4):502–510. DOI: 10.1016/j.jpurol.2021.03.009

[20] Chandrasekharam V.V.S., Babu R. A systematic review and meta-analysis of conventional laparoscopic versus robot-assisted laparoscopic pyeloplasty in infants // J Pediatr Urol. 2021. Vol. 17, No. 4. P. 502–510. DOI: 10.1016/j.jpurol.2021.03.009

[21] Chandrasekharam VVS, Babu R. A systematic review and meta-analysis of conventional laparoscopic versus robot-assisted laparoscopic pyeloplasty in infants. J Pediatr Urol. 2021;17(4):502–510. DOI: 10.1016/j.jpurol.2021.03.009

[22] Tanabe K, Nakamura S, Hyuga T, et al. Retroperitoneoscopy-assisted dismembered pyeloplasty with single-site plus one port in older children with congenital hydronephrosis. Asian J Endosc Surg. 2022;15(2):335–343. DOI: 10.1111/ases.13021

[23] Tanabe K., Nakamura S., Hyuga T., et al. Retroperitoneoscopy-assisted dismembered pyeloplasty with single-site plus one port in older children with congenital hydronephrosis // Asian J Endosc Surg. 2022. Vol. 15, No. 2. P. 335–343. DOI: 10.1111/ases.13021

[24] Tanabe K, Nakamura S, Hyuga T, et al. Retroperitoneoscopy-assisted dismembered pyeloplasty with single-site plus one port in older children with congenital hydronephrosis. Asian J Endosc Surg. 2022;15(2):335–343. DOI: 10.1111/ases.13021

[25] Andolfi C, Adamic B, Oommen J, Gundeti MS. Robot-assisted laparoscopic pyeloplasty in infants and children: is it superior to conventional laparoscopy? World J Urol. 2020;38(8):1827–1833. DOI: 10.1007/s00345-019-02943-z

[26] Andolfi C., Adamic B., Oommen J., Gundeti M.S. Robot-assisted laparoscopic pyeloplasty in infants and children: is it superior to conventional laparoscopy? // World J Urol. 2020. Vol. 38, No. 8. P. 1827–1833. DOI: 10.1007/s00345-019-02943-z

[27] Andolfi C, Adamic B, Oommen J, Gundeti MS. Robot-assisted laparoscopic pyeloplasty in infants and children: is it superior to conventional laparoscopy? World J Urol. 2020;38(8):1827–1833. DOI: 10.1007/s00345-019-02943-z

[28] Hellström J, Giertz G, Lindblom K. Pathogenesis and treatment of hydronephrosis. Presentedat VIII Congreso de la Sociedad International de urologia. Paris, France, 1949.

[29] Hellström J., Giertz G., Lindblom K. Pathogenesis and treatment of hydronephrosis // Presentedat VIII Congreso de la Sociedad International de urologia. Paris, France, 1949.

[30] Hellström J, Giertz G, Lindblom K. Pathogenesis and treatment of hydronephrosis. Presentedat VIII Congreso de la Sociedad International de urologia. Paris, France, 1949.

[31] Chapman TL. Urology in outline. Edinburgh, London: Churchill Livingstone, 1959. 82 p.

[32] Chapman T.L. Urology in outline. Edinburgh, London: Churchill Livingstone, 1959. 82 p.

[33] Chapman TL. Urology in outline. Edinburgh, London: Churchill Livingstone, 1959. 82 p.

[34] Esposito C, Bleve C, Escolino M, et al. Laparoscopic transposition of lower pole crossing vessels (vascular hitch) in children with pelviureteric junction obstruction. Transl Pediatr. 2016;5(4):256–261. DOI: 10.21037/tp.2016.09.08

[35] Esposito C., Bleve C., Escolino M., et al. Laparoscopic transposition of lower pole crossing vessels (vascular hitch) in children with pelviureteric junction obstruction // Transl Pediatr. 2016. Vol. 5, No. 4. P. 256–261. DOI: 10.21037/tp.2016.09.08

[36] Esposito C, Bleve C, Escolino M, et al. Laparoscopic transposition of lower pole crossing vessels (vascular hitch) in children with pelviureteric junction obstruction. Transl Pediatr. 2016;5(4):256–261. DOI: 10.21037/tp.2016.09.08

[37] Miscia ME, Lauriti G, Riccio A, et al. Minimally invasive vascular hitch to treat pediatric extrinsic ureteropelvic junction obstruction by crossing polar vessels: A systematic review and meta-analysis. J Pediatr Urol. 2021;17(4):493–501. DOI: 10.1016/j.jpurol.2021.03.002

[38] Miscia M.E., Lauriti G., Riccio A., et al. Minimally invasive vascular hitch to treat pediatric extrinsic ureteropelvic junction obstruction by crossing polar vessels: A systematic review and meta-analysis // J Pediatr Urol. 2021. Vol. 17, No. 4. P. 493–501. DOI: 10.1016/j.jpurol.2021.03.002

[39] Miscia ME, Lauriti G, Riccio A, et al. Minimally invasive vascular hitch to treat pediatric extrinsic ureteropelvic junction obstruction by crossing polar vessels: A systematic review and meta-analysis. J Pediatr Urol. 2021;17(4):493–501. DOI: 10.1016/j.jpurol.2021.03.002

[40] Gundeti MS, Reynolds WS, Duffy PG, Mushtaq I. Further experience with the vascular hitch (laparoscopic transposition of lower pole crossing vessels): an alternate treatment for pediatric ureterovascular ureteropelvic junction obstruction. J Urol. 2008;180(4S):1832–1836. DOI: 10.1016/j.juro.2008.05.055

[41] Gundeti M.S., Reynolds W.S., Duffy P.G., Mushtaq I. Further experience with the vascular hitch (laparoscopic transposition of lower pole crossing vessels): an alternate treatment for pediatric ureterovascular ureteropelvic junction obstruction // J Urol. 2008. Vol. 180, No. 4S. P. 1832–1836. DOI: 10.1016/j.juro.2008.05.055

[42] Gundeti MS, Reynolds WS, Duffy PG, Mushtaq I. Further experience with the vascular hitch (laparoscopic transposition of lower pole crossing vessels): an alternate treatment for pediatric ureterovascular ureteropelvic junction obstruction. J Urol. 2008;180(4S):1832–1836. DOI: 10.1016/j.juro.2008.05.055

[43] Peters CA, Schlussel RN, Retik AB. Pediatric laparoscopic dismembered pyeloplasty. J Urol. 1995;153(6):1962–1965. DOI: 10.1016/S0022-5347(01)67378-6

[44] Peters C.A., Schlussel R.N., Retik A.B. Pediatric laparoscopic dismembered pyeloplasty // J Urol. 1995. Vol. 153, No. 6. P. 1962–1965. DOI: 10.1016/S0022-5347(01)67378-6

[45] Peters CA, Schlussel RN, Retik AB. Pediatric laparoscopic dismembered pyeloplasty. J Urol. 1995;153(6):1962–1965. DOI: 10.1016/S0022-5347(01)67378-6

[46] Madec F-X, Faraj S, Villemagne T, et al. Laparoscopic transposition of lower-pole crossing vessels: Long-term follow-up of 33 patients at puberty. J Pediatr Urol. 2016;12(4):226.e1–226.e 6. DOI: 10.1016/j.jpurol.2016.03.016

[47] Madec F.-X., Faraj S., Villemagne T., et al. Laparoscopic transposition of lower-pole crossing vessels: Long-term follow-up of 33 patients at puberty // J Pediatr Urol. 2016. Vol. 12, No. 4. P. 226.e1–226.e 6. DOI: 10.1016/j.jpurol.2016.03.016

[48] Madec F-X, Faraj S, Villemagne T, et al. Laparoscopic transposition of lower-pole crossing vessels: Long-term follow-up of 33 patients at puberty. J Pediatr Urol. 2016;12(4):226.e1–226.e 6. DOI: 10.1016/j.jpurol.2016.03.016

[49] Villemagne T, Fourcade L, Camby C, et al. Long-term results with the laparoscopic transposition of renal lower pole crossing vessels. J Pediatr Urol. 2015;11(4):174.e1–174.e7. DOI: 10.1016/j.jpurol.2015.04.023

[50] Villemagne T., Fourcade L., Camby C., et al. Long-term results with the laparoscopic transposition of renal lower pole crossing vessels // J Pediatr Urol. 2015. Vol. 11, No. 4. P. 174.e1–174.e7. DOI: 10.1016/j.jpurol.2015.04.023

[51] Villemagne T, Fourcade L, Camby C, et al. Long-term results with the laparoscopic transposition of renal lower pole crossing vessels. J Pediatr Urol. 2015;11(4):174.e1–174.e7. DOI: 10.1016/j.jpurol.2015.04.023

[52] Shen LT, Tou J. Application and prospects of robotic surgery in children: a scoping review. World J Pediatr Surg. 2022;5(4):e000482. DOI: 10.1136/wjps-2022-000482

[53] Shen L.T., Tou J. Application and prospects of robotic surgery in children: a scoping review // World J Pediatr Surg. 2022. Vol. 5, No. 4. ID e000482. DOI: 10.1136/wjps-2022-000482

[54] Shen LT, Tou J. Application and prospects of robotic surgery in children: a scoping review. World J Pediatr Surg. 2022;5(4):e000482. DOI: 10.1136/wjps-2022-000482

[55] Cundy TP, Harley SJD, Marcus HJ, et al. Global trends in paediatric robot-assisted urological surgery: a bibliometric and Progressive Scholarly Acceptance analysis. J Robot Surg. 2018;12(1):109–115. DOI: 10.1007/s11701-017-0703-3

[56] Cundy T.P., Harley S.J.D., Marcus H.J., et al. Global trends in paediatric robot-assisted urological surgery: a bibliometric and Progressive Scholarly Acceptance analysis // J Robot Surg. 2018. Vol. 12, No. 1. P. 109–115. DOI: 10.1007/s11701-017-0703-3

[57] Cundy TP, Harley SJD, Marcus HJ, et al. Global trends in paediatric robot-assisted urological surgery: a bibliometric and Progressive Scholarly Acceptance analysis. J Robot Surg. 2018;12(1):109–115. DOI: 10.1007/s11701-017-0703-3

[58] Morales-López RA, Pérez-Marchán M, Pérez Brayfield M. Current concepts in pediatric robotic assisted pyeloplasty. Front Pediatr. 2019;7:4. DOI: 10.3389/fped.2019.00004

[59] Morales-López R.A., Pérez-Marchán M., Pérez Brayfield M. Current concepts in pediatric robotic assisted pyeloplasty // Front Pediatr. 2019. Vol. 7. ID 4. DOI: 10.3389/fped.2019.00004

[60] Morales-López RA, Pérez-Marchán M, Pérez Brayfield M. Current concepts in pediatric robotic assisted pyeloplasty. Front Pediatr. 2019;7:4. DOI: 10.3389/fped.2019.00004

[61] Song SH, Lee C, Jung J, Kim SJ, et al. A comparative study of pediatric open pyeloplasty, laparoscopy-assisted extracorporeal pyeloplasty, and robot-assisted laparoscopic pyeloplasty. PLoS One. 2017;12(4):e0175026. DOI: 10.1371/journal.pone.0175026

[62] Song S.H., Lee C., Jung J., Kim S.J., et al. A comparative study of pediatric open pyeloplasty, laparoscopy-assisted extracorporeal pyeloplasty, and robot-assisted laparoscopic pyeloplasty // PLoS One. 2017. Vol. 12, No. 4. ID e0175026. DOI: 10.1371/journal.pone.0175026

[63] Song SH, Lee C, Jung J, Kim SJ, et al. A comparative study of pediatric open pyeloplasty, laparoscopy-assisted extracorporeal pyeloplasty, and robot-assisted laparoscopic pyeloplasty. PLoS One. 2017;12(4):e0175026. DOI: 10.1371/journal.pone.0175026

[64] Kafka IZ, Kocherov S, Jaber J, Chertin B. Pediatric robotic-assisted laparoscopic pyeloplasty (RALP): does weight matter? Pediatr Surg Int. 2019;35(3):391–396. DOI: 10.1007/s00383-019-04435-y

[65] Kafka I.Z., Kocherov S., Jaber J., Chertin B. Pediatric robotic-assisted laparoscopic pyeloplasty (RALP): does weight matter? // Pediatr Surg Int. 2019. Vol. 35, No. 3. P. 391–396. DOI: 10.1007/s00383-019-04435-y

[66] Kafka IZ, Kocherov S, Jaber J, Chertin B. Pediatric robotic-assisted laparoscopic pyeloplasty (RALP): does weight matter? Pediatr Surg Int. 2019;35(3):391–396. DOI: 10.1007/s00383-019-04435-y

[67] Kovarsky SL, Zakharov AI, Sottaeva ZZ, et al. Vasopexy in children with hydronephrosis. Russian Journal of Pediatric Surgery. 2016;20(4):175–177. DOI: 10.18821/1560-9510-2016-20-4-175-177

[68] Коварский С.Л., Захаров А.И., Соттаева З.З., и др. Вазопексия при гидронефрозе у детей // Детская хирургия. 2016. Т. 20, № 4. С. 175–177. DOI: 10.18821/1560-9510-2016-20-4-175-177

[69] Kovarsky SL, Zakharov AI, Sottaeva ZZ, et al. Vasopexy in children with hydronephrosis. Russian Journal of Pediatric Surgery. 2016;20(4):175–177. DOI: 10.18821/1560-9510-2016-20-4-175-177

[70] Godbole P, Mushtaq I, Wilcox DT, Duffy PG. Laparoscopic transposition of lower pole vessels e “the vascular hitch”: an alternative to dismembered pyeloplasty for pelvi-ureteric junction obstruction in children. J Pediatr Urol. 2006;2(4):285–289. DOI: 10.1016/j.jpurol.2005.11.017

[71] Godbole P., Mushtaq I., Wilcox D.T., Duffy P.G. Laparoscopic transposition of lower pole vessels e “the vascular hitch”: an alternative to dismembered pyeloplasty for pelvi-ureteric junction obstruction in children // J Pediatr Urol. 2006. Vol. 2, No. 4. P. 285–289. DOI: 10.1016/j.jpurol.2005.11.017

[72] Godbole P, Mushtaq I, Wilcox DT, Duffy PG. Laparoscopic transposition of lower pole vessels e “the vascular hitch”: an alternative to dismembered pyeloplasty for pelvi-ureteric junction obstruction in children. J Pediatr Urol. 2006;2(4):285–289. DOI: 10.1016/j.jpurol.2005.11.017

[73] Sakoda A, Cherian A, Mushtaq I. Laparoscopic transposition of lower pole crossing vessels (‘vascular hitch’) in pure extrinsic pelvi-ureteric junction (PUJ) obstruction in children. BJU Int. 2011;108(8):1364–1368. DOI: 10.1111/j.1464-410X.2011.10657.x

[74] Sakoda A., Cherian A., Mushtaq I. Laparoscopic transposition of lower pole crossing vessels (‘vascular hitch’) in pure extrinsic pelvi-ureteric junction (PUJ) obstruction in children // BJU Int. 2011. Vol. 108, No. 8. P. 1364–1368. DOI: 10.1111/j.1464-410X.2011.10657.x

[75] Sakoda A, Cherian A, Mushtaq I. Laparoscopic transposition of lower pole crossing vessels (‘vascular hitch’) in pure extrinsic pelvi-ureteric junction (PUJ) obstruction in children. BJU Int. 2011;108(8):1364–1368. DOI: 10.1111/j.1464-410X.2011.10657.x

[76] Chiarenza SF, Bleve C, Fasoli L, et al. Ureteropelvic junction obstruction in children by polar vessels. Is laparoscopic vascular procedure a good solution? Single center experience on 35 consecutive patients. J Pediatr Surg. 2016;51(2):310–314. DOI: 10.1016/j.jpedsurg.2015.10.005

[77] Chiarenza S.F., Bleve C., Fasoli L., et al. Ureteropelvic junction obstruction in children by polar vessels. Is laparoscopic vascular procedure a good solution? Single center experience on 35 consecutive patients // J Pediatr Surg. 2016. Vol. 51, No. 2. P. 310–314. DOI: 10.1016/j.jpedsurg.2015.10.005

[78] Chiarenza SF, Bleve C, Fasoli L, et al. Ureteropelvic junction obstruction in children by polar vessels. Is laparoscopic vascular procedure a good solution? Single center experience on 35 consecutive patients. J Pediatr Surg. 2016;51(2):310–314. DOI: 10.1016/j.jpedsurg.2015.10.005

[79] Schneider A, Gomes Ferreira C, Delay C, et al. Lower pole vessels in children with pelviureteric junction obstruction: laparoscopic vascular hitch or dismembered pyeloplasty? J Pediatr Urol. 2013;9(4):419–423. DOI: 10.1016/j.jpurol.2012.07.005

[80] Schneider A., Gomes Ferreira C., Delay C., et al. Lower pole vessels in children with pelviureteric junction obstruction: laparoscopic vascular hitch or dismembered pyeloplasty? // J Pediatr Urol. 2013. Vol. 9, No. 4. P. 419–423. DOI: 10.1016/j.jpurol.2012.07.005

[81] Schneider A, Gomes Ferreira C, Delay C, et al. Lower pole vessels in children with pelviureteric junction obstruction: laparoscopic vascular hitch or dismembered pyeloplasty? J Pediatr Urol. 2013;9(4):419–423. DOI: 10.1016/j.jpurol.2012.07.005

[82] Al-Emadi I, Juricic M, Mouttalib S, et al. Laparoscopic vascular hitch for polar vessels in pyeloureteric junction obstruction: medium-term follow-up of a monocentric experience. Eur J Pediatr Surg. 2021;31(3):282–285. DOI: 10.1055/s-0040-1713177

[83] Al-Emadi I., Juricic M., Mouttalib S., et al. Laparoscopic vascular hitch for polar vessels in pyeloureteric junction obstruction: medium-term follow-up of a monocentric experience // Eur J Pediatr Surg. 2021. Vol. 31, No. 3. P. 282–285. DOI: 10.1055/s-0040-1713177

[84] Al-Emadi I, Juricic M, Mouttalib S, et al. Laparoscopic vascular hitch for polar vessels in pyeloureteric junction obstruction: medium-term follow-up of a monocentric experience. Eur J Pediatr Surg. 2021;31(3):282–285. DOI: 10.1055/s-0040-1713177

[85] Kim JK, Keefe DT, Rickard M, et al. Vascular hitch for paediatric pelvi-ureteric junction obstruction with crossing vessels: institutional analysis and systematic review with meta-analysis. BJU Int. 2022;129(6):679–687. DOI: 10.1111/bju.15342

[86] Kim J.K., Keefe D.T., Rickard M., et al. Vascular hitch for paediatric pelvi-ureteric junction obstruction with crossing vessels: institutional analysis and systematic review with meta-analysis // BJU Int. 2022. Vol. 129, No. 6. P. 679–687. DOI: 10.1111/bju.15342

[87] Kim JK, Keefe DT, Rickard M, et al. Vascular hitch for paediatric pelvi-ureteric junction obstruction with crossing vessels: institutional analysis and systematic review with meta-analysis. BJU Int. 2022;129(6):679–687. DOI: 10.1111/bju.15342

[88] Polok M, Toczewski K, Borselle D, et al. Hydronephrosis in children caused by lower pole crossing vessels-how to choose the proper method of treatment? Front Pediatr. 2019;7:83. DOI: 10.3389/fped.2019.00083

[89] Polok M., Toczewski K., Borselle D., et al. Hydronephrosis in children caused by lower pole crossing vessels-how to choose the proper method of treatment? // Front Pediatr. 2019. Vol. 7. ID 83. DOI: 10.3389/fped.2019.00083

[90] Polok M, Toczewski K, Borselle D, et al. Hydronephrosis in children caused by lower pole crossing vessels-how to choose the proper method of treatment? Front Pediatr. 2019;7:83. DOI: 10.3389/fped.2019.00083

[91] Kozlov Yu.A., Poloyan S.S., Bregel L.V. et al. Laparoscopic relocation of aberrant renal vessels in the treatment of congenital hydronephrosis. Pediatric surgery. 2022;26(3):135–141. DOI: 10.55308/1560-9510-2022-26-3-135-141.

[92] Козлов Ю.А., Полоян С.С., Брегель Л.В. и др. Лапароскопическое перемещение аберрантных почечных сосудов в лечении врождённого гидронефроза // Детская хирургия. 2022. Т. 26, № 3. С. 135–141. DOI: 10.55308/1560-9510-2022-26-3-135-141

[93] Kozlov Yu.A., Poloyan S.S., Bregel L.V. et al. Laparoscopic relocation of aberrant renal vessels in the treatment of congenital hydronephrosis. Pediatric surgery. 2022;26(3):135–141. DOI: 10.55308/1560-9510-2022-26-3-135-141.

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