Laparoscopic-Assisted Extravesical Ureteral Reimplantation and Extracorporeal Ureteral Tapering Repair for Primary Obstructive Megaureter in Children.
J Laparoendosc Adv Surg Tech A
; 27(8): 851-857, 2017 Aug.
Article
em En
| MEDLINE
| ID: mdl-28594594
ABSTRACT
BACKGROUND:
Open surgery is a preferred treatment for primary obstructive megaureter (POM) in cases where the conservative treatment fails, with reported success rates of 90%-96%.OBJECTIVE:
To describe our initial experience in the treatment of POM by laparoscopic-assisted extracorporeal ureteral tapering repair (EUTR) and laparoscopic ureteral extravesical reimplantation (LUER) by following Lich Gregoir technique as an alternative to open surgery. DESIGN, SETTING, ANDPARTICIPANTS:
A total of 7 patients with POM underwent laparoscopic-assisted extracorporeal ureteral tapering repair and ureteral extravesical reimplantation by following Lich Gregoir technique between 2011 and 2014. Postoperative follow-up included the following Renal and bladder ultrasound, voiding cystourethrogram (VCUG), and mercaptoacetyltriglycine (MAG3) renogram were done at 6 months. Outcome Measurements and StatisticalAnalysis:
Statistical analysis was performed by using the SPSS software package (version 15.0; SPSS, Chicago, IL), and P < .05 was considered statistically significant. Paired tests and Wilcoxon test were performed to compare pre- and post-measures.RESULTS:
LUER and EUTR were completed successfully in all patients without conversion. A postoperative MAG3 renogram showed nonobstructive pattern in all patients. Statistical analysis revealed significant differences before and after surgery in the average time of elimination on the MAG3 renogram (T½ 59.10 minutes versus 13.57 minutes, P < .0001). After medium-term follow-up, the overall POM resolution was 100%. One case of vesicoureteral reflux (VUR) was found during VCUG control. A total of 7 patients were asymptomatic without recurrence of POM.CONCLUSION:
Laparoscopic-assisted extracorporeal ureteral tapering repair and ureteral extravesical reimplantation by following Lich Gregoir technique for POM constitutes a safe and good option when the first line of treatment fails, with a success rate similar to the open procedure. Nevertheless, larger randomized prospective trials and long-term follow-up are required to validate this technique.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Procedimentos Cirúrgicos Urológicos
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Ureter
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Obstrução Ureteral
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Laparoscopia
Tipo de estudo:
Observational_studies
Limite:
Child, preschool
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Female
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Humans
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Infant
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Male
Idioma:
En
Revista:
J Laparoendosc Adv Surg Tech A
Ano de publicação:
2017
Tipo de documento:
Article