643
2335580226014562122179
Ces37077936014570127174
Urol39067936014578115180208
2021;41397936014562121178233249
25(4):44137936014562122153209240262
231–23547007936014562122176230285345403
VIDEO4696207016978121223301405
se62489801314193
tak74089801313079124
stent88789801313771121178209
syndromu111989801313785144202233288377433
a1576898013145
další1645898013155103125162183
celkové185289801314595117161217264315
anestezii2191898013145102154194227278321343364
nut‑2579898013154111143171
né6241048013158109
k7561048013142
extrakci821104801314894129160208252297318
stentu1162104801313669119175205261
u14461048013153
dítěte1522104801315576108157188238
Pooperační17991048013150104161219272302350397453474
průběh2296104801315586142200252308
byl26271048013155101123
bez6241198013161115159
komplikací,8071198013148105195254277299344395443465483
bolesti13141198013162121144197237272294
vymizely,16321198013151103193215259310333381394
dilatace2050119801316183105153185235284335
kalicho‑2409119801314798120142190248306341
pánvičkového6241348013161111168216238287332388437489547605
systému1253134801314695136170221310367
se1644134801314699
s17671348013146
odstupem18371348013163124163198255315369458
tří231913480131397093
měsíců24361348013195148188209257314
zmenšila6241498013144134187245284306328376
a10241498013147
na10951498013155104
Dopplerovském12231498013167126186247270323354410459499544596685
zobrazení1932149801314097157189239284335393415
je2371149801312072
patrné24671498013157107139171230283
příznivé624164801316090112154212232280331
kraniální978164801314274122179199246268324344
vychýlení1346164801314495141197242264316372393
aberantní17621648013145103156186235291322378399
cévy2184164801314494141192
a23991648013145
zacho‑2467164801314089136192249283
valá6241798013150100122170
perfuze8181798013161115147179238282333
dolního11751798013160118141199220280339
pólu15381798013161120143200
ledviny1762179801312376136186208266312
Laparoskopickou7741948013149100160210241298338383440500522571616673731
transpozici1529194801314274124182221280340382405453475
aberantních20281948013158117172203253311343401423471528
cév,25811948013157108156169
tzv624209801313481133
„vascular795209801313075125164213270293341372
hitch“1191209801315779112158216245
poprvé14602098013159118178210263315
popsali17992098013159118178218268291312
Meng21352098013183137195254
a24132098013148
Stoller2485209801314980136159181233265
v6242248013151
r6992248013142
20037802248013163116172223
(6)1028224801313890117
Od11852248013184146
té1356224801314295
doby14762248013169128190238
vyšla17392248013159112154176226
řada1990224801314192153203
prací22182248013170103154204227
potvr‑24702248013170130163217251280
zujících6242398013144103125147195217265323
bezpečnost9712398013169124168229283333391449489524
provedení15192398013169101158207259319372430452
této1995239801314394127183
operace22022398013167128182214264313364
Její2607239801314699121143
úspěšnost624254801315897156209248306363403437
(97,51085254801312573123128181
%12902548013177
±13912548013161
1,61476254801314961114
%)16142548013177102
je1739254801312072
srovnatelná1835254801313767123171230278310360383440488
s23472548013137
resekční2407254801312980120172218264321343
pyeloplastikou6242698013160107159181239298321369409443465510566623
(9)1271269801312574100
Výhodou14102698013152101159217277334392
je1826269801311971
bezstentová19212698013157110155197231282339371426474523
opera‑24682698013155114168199249282
ce6242848013149100
s7482848013141
kratší813284801314780130162204225
délkou10622848013160113136180237295
operace13812848013159119173204254303354
a17592848013150
hospitalizace18332848013159117157216239272322344366409460509560
(9,241728480131297892
10)25332848013154101128
Závěr:7742992013764124182239283313
Laparoskopická11192998013149101162213246304345391449511535584631683
transpozice1827299801314376127186227287348391415465517
aberant‑23692998013159120175208259318351381
ních624314801316084135196
cév8463148013160114166
je1038314801313489
alternativou1154314801316185121175209271322357381433493555
resekční1735314801314397140196245295355379
pyeloplastiky21413148013172122177201263326351403445482507555609
u6243298013159
vybraných7093298013159113175209260320368417476
pacientů12113298013171122173196250310343402
s16393298013151
intermitentní1715329801313392126178211303326361414474507567590
hydrone‑23313298013169116177210268328383419
frózou,624344801312963120164221281300
pokud9493448013166126173232293
při1267344801316699122
operaci14143448013164125180213264314336
vyloučíme17763448013154108132191250300322412467
současnou22683448013146105164214264305364423482
vlastní624359801315075125166202262285
„intrinzickou“935359801314266126159192216276321346395442501561593
obstrukci15543598013168130172208241301348397420
PUJ20003598013165133168
Nevyžaduje22133598013180135185239287339400459483537
inzerci624374801312382127180213261284
stentu933374801315186139198231290
a12483748013160
zkracuje13333748013153101136187237295319373
délku17313748013169123147194253
operace20093748013168130185218269319371
i24053748013133
hospi‑24633748013168128169229253287
talizace624389801313485108131176227277329
KLÍČOVÁ6254184014770132164236320392464
SLOVA11154184014763124208280352
Hydronefróza,6244348013170120179212270329384413447505548600619
obstrukce12684348013168130171206239298345393445
pyeloureterální17384348013170119172195255314346399433485518569592651673
junkce,2436434801313291150196245297314
vascular624449801314998137184241262310340
hitch,987449801315576108153210227
transpozice1238449801312960109166204262320361383430480
aberantních17424498013145103156187236292323380401448505
cév2270449801314594142
ledviny2436449801311970129178200256301
SUMMARY6254784014762143243345423493561
Kočvara7744948013156114165218269302353
R,1152494801316586
Sedláček12634948013161115177200250300352399
J,1687494801314765
Drlík17774948013181114138160209
M20114948013196
Laparoscopic21534948013158110172223255313355405462524547597
transposition624509801313466116173213272331371392426448506564
of1212509801315786
crossing1322509801314779135175215236294353
vessels16995098013149101141181234256295
(„vascular2018509801312863107157197246303325374405
hitch2447509801315879113159217
“)2688509801313162
in624524801312381
ureteropelvic729524801316193144177228260316377431453502525573
junction1326524801312784142191227249307365
obstruction17155248013162122162197229287336372394451510
–22495248013158
a23325248013153
case24095248013152102142195
re‑2628524801313688122
port6245398013161120152189
Aimof774554301356995186265299
the1095554301353495150
study:1267554301354178139201255280
Crossing1570554801315787142181219240296354
vessels1947554801314495134172224245283
of2253554801315381
the2357554801312986137
lower2517554801311975152202233
renal624569801313284142191213
pole8615698013168127150203
are1088569801315788140
found1252569801313693151209268
in1544569801313188
10–1516565698013161108166212257
%19375698013188
of2050569801316594
children21685698013156114135157216248299357
with25495698013187109143201
ureteropelvic624584801315992145179231263321383438462512536585
junction1234584801313391150200237260319379
(UPJ)16385848013138107163192221
obstruction,18835848013168130171207240299349386409469529547
and24555848013159119180
in2659584801313291
more6245998013190148180232
than880599801313896144202
half11065998013163112134162
of1292599801316290
older1407599801316285144197228
children16595998013153111132154213245296354
and20375998013154111171
adolescents22325998013153113171194247287336387445476518
(2)624614801312979105
The7676148013146105157
obstruction,9476148013154114153186217275322358379436493511
caused1481614801314593150188240299
by18046148013156102
external1929614801314996132182212270318339
pressure2292614801315687138177216272302353
of2668614801315482
the624629801313492145
vessels7936298013152104144184237260299
on11166298013161119
the1259629801313795148
UPJ14316298013171125153
or1608629801316193
proximal1725629801316395152198220309358380
ureter,2129629801316192143177227259272
is2425629801312665
often2514629801316189127178236
intermittent624644801312381112163195285306340376427485517
and11656448013150108167
manifests13566448013190139197218247299339374415
by17956448013161108
recurrent1927644801313384134191222255306364396
and23476448013150107167
even25386448013153102154212
colic6246598013149105128150198
pain8466598013163113134192
In1081659801312583
an11886598013152110
acute13226598013152101158191242
condition,15896598013151107165225246280302359418436
we20496598013182134
can22076598013151101158
detect23906598013161114147198248284
a26986598013152
high624674801316083144203
grade8526748013170102154215269
hydronephrosis11466748013169116177209267327382444504536594636658698
that18696748013143103154187
may208167480131100151199
disappear2305674801316992132184245307363413445
after624689801315078115166198
resolution846689801313991131189212269303325382441
of1311689801316594
the1429689801314199152
acute16056898013157105163196247
episode18766898013160120143181240300353
The22706898013158118171
aim2465689801315779167
of2656689801316694
this624704801313491113151
video799704801314668127179238
is1060704801312058
to1142704801313085
show1251704801313794152229
intraoperative1504704801311976108139188246306359390440472493542594
evaluation2121704801315098147169226274306328385443
and25877048013146104163
policy6247198013160118141161209259
in906719801311975
hydronephrosis10047198013155100157188243301353411469499554594614652
accompanied1680719801314593138193281340389445466518577
by22807198013156103
crossing2406719801314475131170209229286344
vessels6247348013151104145187241265305
and9547348013159118179
performance11587348013171126159192251284376426486536588
of1771734801316897
laparoscopic1894734801313282143194227285326376434495519569
repair2488734801314194155207229262
without6247498013179102135193252310343
opening9917498013157118172230251309368
of1383749801315886
the1493749801313391144
urinary1661749801315789111169217249301
tract1986749801313264114163199
according2209749801314997144200232289311369428
to2661749801313389
Hellström6247648013169122145167206240272328418
(1)106676480131297797
Methods:3126893013591148187250311376421447
Doppler3597898013173132192252275328360
ultrasound398189801316082115147197237295353411470
examination4475898013155103152241263320369401423481540
is503989801312463
of2976104801315886
paramount30861048013157106137186275333390447479
importance35891048013119107166224256293342399447498
in4110104801311977
detection42101048013156108141192241276298355414
of4647104801315583
crossing4753104801314577133172212233290349
vessels29761198013151104146187242265305
of3306119801316998
the34291198013143103158
lower3612119801313292172226258
renal3896119801314194154204227
pole41481198013171132156210
On44011198013184145
intravenous4571119801313291124157209258311371431490531
urography,2976134801315990147207239289349408454467
a34671348013159
globular3550134801316890148209267290338370
shape39441348013149107156216270
of4238134801316796
the43581348013142100154
pelvis45361348013169123146195218258
with48181348013188110144202
a50441348013159
flat2976149801312753102134
bottom31341498013169128161197253343
and35011498013158116175
calyceal37001498013157107130178225276324346
dilatation4071149801316789111160192242274296354413
has45081498013167115155
been46871498013169123177235
de‑49461498013168121156
scribed2976164801314088118140198251310
in3309164801311875
crossing3407164801314474130169207228284342
vessels3772164801314595135173225247284
(3)408016480131247498
Surgery42151648013146102132188240270321
is4559164801311956
considered4639164801314498156194214272324354404463
in2976179801312380
confirmed30801798013144100158183209240329382441
UPJ35451798013165118146
obstruction37141798013155114154188219277325361382440498
based42351798013157106145198258
on45161798013155113
symptoms4652179801313786176234267322411450
and29761948013150108167
findings3167194801312754111171193250310349
on35401948013159117
dynamic36811948013160109168217305327375
renal4081194801313284142191213
scintigraphy4318194801314190112169201223282313363423482528
or4870194801315991
on49851948013158117
intravenous2976209801312378109139188234284340396453490
urography3489209801315383138197227275333390434
with3946209801317495127183
furosemide4152209801312482112166205256343364421472
Functional4663209801314699155202237258314371418439
magnetic29762248013190139198256309342364413
resonance3413224801313182123181239288346394445
urography3882224801315789145205237287346405451
is4357224801312261
a44422248013148
good45142248013159117176236
alterna‑4774224801314971104155187246294328
tive,2976239801313456105157174
moreover,31742398013198157189240299348400431444
detecting36422398013168121154205255291313371430
the40962398013142100153
crossing4274239801315788145185225246304363
vessels46612398013158110150190243266304
(4)4990239801313786112
CT29762548013163117
urography3117254801315586142202233283343401447
is3588254801311958
inappropriate3670254801312077126185245277333393425448496528579
in4273254801311977
children43742548013145103124146205236288345
because47432548013157111161210267306359
of2976269801315987
a30872698013150
high3161269801315981140197
radiation3383269801313282141163211244266323382
burden37892698013161119150208261319
If3126284801312349
the3197284801312884135
vascular3354284801314391128175230250296325
hitch3701284801315373104148203
is3926284801311855
being40032848013154106126181238
considered,4263284801314396152190209266316345394452468
it4753284801311849
should4824284801313590146201222278
be29762998013162116
born31152998013169129160219
in3358299801313188
mind,34702998013199120178237255
that37492998013141100148180
an39532998013158116
„extrinsic4093299801313993140177208230288327348396
obstruction45132998013167127167201233291340376398455514
“,5051299801314051
caused2976314801314997153190242301
by32993148013156101
external3423314801314894129179209266313334
pressure3780314801315586136174213268298348
of4150314801315380
vessels4253314801314595134172224245282
or4558314801315384
adhesions,46643148013145103159211249269325382420437
may29763298013190138183
be31823298013158111
accompanied3316329801314795140195283342391447468519579
by39183298013158104
an40453298013147103
„intrisic“4171329801313052108139170191229249297328
obstruction,45223298013156115154188218276323358379436493510
a50553298013147
real2976344801313283130151
UPJ31503448013173126153
or3326344801316293
proximal3442344801316596152196217305353374
ureter3839344801316393143175225255
stenosis4117344801314679129186243282302340
with44803448013183105137194
pathohis‑46973448013165114145202259317337375405
tological2976359801313489111168227248295343365
changes33643598013149105153209268320359
in3746359801312379
the3848359801313491143
ureteric4014359801315888139171221251272319
wall43563598013180128149170
In4566359801312380
this4669359801313491111149
case4841359801314998136188
a50523598013150
dismembered2976374801316081118206258346404457488538597
repair3596374801313182140189210240
should3859374801314096153210231289
be41713748013160113
performed43073748013160112143174230261349402461
(3)4791374801312877101
Hellström31263898013169122145167206240272328418
described35683898013165118158207238261320374434
elevation4026389801315881134183232265287344403
and44533898013155112172
adventitial46493898013155114164215273305327360383431453
fixation2976404801312753100150182204262320
of3320404801316795
the34394048013142100153
vessels36164048013158110150190243265304
to3944404801314298
the40664048013142100153
renal4244404801314091149198220
pelvis44884048013169123146195218257
outside47694048013166124158199221280333
the2976419801313492145
region3145419801313687148169227286
of3455419801316290
UPJ35694198013172126154
in3747419801312684
194938554198013157102156206
(1)4085419801313380100
Chapman42254198013166123172231321370428
proposed4677419801316496152212272312365425
to2976434801313388
stabilise3087434801313670118176198219239277329
the3439434801312986137
vessels3599434801314596135173225246284
in3906434801311975
the4004434801312986137
new41644348013154106183
position43704348013155113152172204225282339
by47324348013155101
wrap‑48564348013174105154212246
ping2976449801316286146208
them32104498013143104159251
in3487449801313292
the36044498013144105160
pelvic37894498013171128152203227277
wall40924498013190142166189
This43264498013161124147188
method453944980131101157192252313376
has49404498013169120162
gained29764648013160109131188241302
popularity33024648013169128188246268317348371405456
in3782464801313189
selected38954648013149102124177227263314375
patients42944648013168118151173225283315357
especially46754648013161102161215264286335357379427
after2976479801315078116167198
introduction3198479801313289121153210270327376412434492551
of3773479801316795
laparoscopy3892479801313280140190221278318367423484531
as4447479801315898
an45694798013158116
easier47094798013162110150171224255
al‑4988479801315881114
ternative2976494801313486117176226258280330382
to3382494801314399
technically3505494801314394144202260282331381403425473
demanding40034948013168121211260318378400458518
laparoscopic4545494801313280140191222279320369425486508557
suturing2976509801314199133191223246304364
in3365509801313190
dismembered3479509801316991131220274364425479511563625
pyeloplasty41285098013170117170193252313336386426461513
(5–7)4666509801313789145193222
The49285098013160120174
Chapman29765248013163120169229318367425
modification34255248013187145205227253280328378410432490548
has39975248013156105144
been41665248013157111165223
used4413524801315594147207
in4644524801312078
our47465248013155113144
case4914524801314695135188
as2976539801315089
well30895398013175127149170
Surgery33015398013147103134192244275326
has36515398013155103143
three3817539801313088119170223
phases40645398013156115163202255295
First,440253980131476899139173192
releasing4618539801312879101154201241262319378
of5019539801315583
crossing2976554801314980137177217238296355
vessels33555548013152104144184237260299
from3678554801313164121210
the3912554801313795148
pelvis40845548013163117140189212251
and43595548013152110170
ureter4553554801316192143177228259
is4836554801312665
per‑49255548013163117148177
formed2976569801312986118208261321
and33215698013155113172
the3517569801313997150
vessels36915698013154106146186239262301
are4016569801315485137
freely4177569801313366118172194242
pulled44435698013165124146167220280
cranially4748569801315385134192214262284306354
outside29765848013159116150192213272325
the3325584801313492145
UPJ34945848013168122150
region3668584801313284144166224282
The39935848013151111164
second4181584801314094143199257317
phase45225848013160119168207260
should4807584801314098156214236295
prove2976599801316194152201254
free3254599801313871124179
passage34575998013170121161202253314367
of3849599801316897
urine39705998013168100123181235
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liquid4465599801313153113172194254
infusion4744599801313190118178218240299358
and29766148013150108167
furosemide3167614801313795127183223276365387446499
administration36906148013158117206228285307346381412462494517574633
It4366614801313064
is4454614801313069
necessary45476148013167120169220260300350382433
to5004614801314298
wait29766298013180131153187
1031886298013162110
minutes33236298013199121180238272324365
to37126298013143100
achieve38366298013159109167189243292345
full4206629801313797119142
diuretic4372629801316991149181233267290339
effect4735629801316392122175225262
If5041629801313261
UPJ29766448013169124152
obstruction31536448013167127168203235294343380402460519
persists36976448013169124155197219258293335
at4056644801315991
visual4172644801315881121178227249
control,44466448013157114173205237294318336
then48066448013142101154213
a50436448013159
dismembered2976659801316082121209262351411465496548608
repair3608659801313789148198220251
is3883659801312766
to3973659801313995
be40926598013165119
used42356598013162102155215
(8)4474659801313384111
During46246598013175134165188245305
the4953659801313896149
third2976674801313493115147206
phase,32076748013169129178219273290
the35216748013143102156
vessels37016748013159111152193247270309
are4035674801315991143
wrapped42026748013189122172233294349410
within46376748013188111145204226285
the49466748013143102156
anterior29766898013151110143196228251311344
pelvic33456898013170126149200223273
wall36436898013189140164186
at3854689801315993
the39726898013143102157
elevated4154689801316386141191242275328389
position45686898013171132173195229252312372
ac‑49656898013159109137
cording29767048013149105137195217274334
to3334704801313490
Chapman34487048013162120169228318367425
Results31267193013564122169232261301348
and34987193013565129194
discussion:37167193013573102149200263310356385448513538
An42807198013174133
8-year-old4438719801316398148201250283313375399460
boy49237198013170131179
was29767348013179129168
investigated3168734801311976123175215249271330378410461521
because37137348013157110159209266305358
of4094734801315583
intermittent4201734801311977108159190280301334371421479510
abdomi‑47357348013146106166223313334367
nal29767498013159108130
pain31307498013163113135192
Grade33657498013171103153213266
II3655749801312547
hydronephrosis37267498013162108166197254312366425484515572612633672
of4422749801316189
the4535749801313795148
right4707749801313457116174206
kid‑4937749801314972132165
ney29767648013159113161
with31627648013188111144203
crossing3389764801315890147187228249307367
vessels37817648013158110151191245268307
to4113764801314299
the42367648013142101155
lower4415764801313290169222254
pole46937648013169129153206
was49247648013188138178