La chirurgie du double-rein chez l’enfant pose des problèmes complexes. Cette malformation, relativement fréquente, exige une sanction chirurgicale dans 50% des cas environ. Les indications opératoires sont données par des accidents lies à des anomalies rénales, urétérales ou urétéro-vésicales. L’opération vise à restaurer des conditions anatomíques normales, c’est-à-dire à transformer le rein double en rein unique par anastomose inter-pyélique et suppression d’un des uretères, ou par héminéphrectomie, toujours associée à une urétérectomie. Les malformations de la jonction urétéro-vésicale sont corrigées par une urétéro-cystonéostomie, avec creation d’une papille antireflux. L’imprégnation du rein à exciser au bleu de méthylène facilite l’héminéphrectomie en précisant les limites de l’hémi-rein.

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© 1965 S. Karger AG, Basel
1965
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