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Initial Experience With Laparoscopic Ipsilateral Ureteroureterostomy in Infants and Children for Duplication Anomalies of the Urinary Tract

2007; Lippincott Williams & Wilkins; Volume: 177; Issue: 6 Linguagem: Inglês

10.1016/j.juro.2007.01.177

1527-3792

Ricardo González, Lisandro Piaggio,

Urinary and Genital Oncology Studies

No AccessJournal of UrologyPediatric urology1 Jun 2007Initial Experience With Laparoscopic Ipsilateral Ureteroureterostomy in Infants and Children for Duplication Anomalies of the Urinary Tract Ricardo González and Lisandro Piaggio Ricardo GonzálezRicardo González and Lisandro PiaggioLisandro Piaggio View All Author Informationhttps://doi.org/10.1016/j.juro.2007.01.177AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We report the feasibility of laparoscopic ipsilateral ureteroureterostomy for duplication anomalies of the urinary tract in infants and children, and the short-term results in 6 patients. Materials and Methods: Laparoscopic ipsilateral ureteroureterostomy was performed transperitoneally with 3 and 4 ports for unilateral and bilateral cases, respectively. Cystoscopy, retrograde pyelogram and stent placement in the recipient ureter were performed at the beginning of each case. The anastomosis was carried out with running or interrupted 6-zero sutures. An abdominal drain and Foley catheter were left indwelling in all cases. Demographic data, body measurements, type of procedure and indication, laterality, intraoperative and postoperative complications, analgesia requirement, length of hospitalization and outcome were recorded. Results: Eight laparoscopic ipsilateral ureteroureterostomies were performed in 6 patients (2 males). Mean patient age was 51 months. Diagnoses were bilateral lower pole vesicoureteral reflux (2 patients) and ectopic ureter (4). Mean operative time including cystoscopy was 257 minutes (range 140 to 430) and estimated mean blood loss was 2.7 ml. There were no intraoperative complications. Mean morphine requirement was 0.13 mg/kg. Two cases required acetaminophen only for pain management. All patients were discharged home with no narcotics at a median of 3 days postoperatively (range 1 to 7). There were 2 postoperative febrile urinary tract infections. Followup renal ultrasound demonstrated no significant hydronephrosis of the moieties involved. Conclusions: In this initial experience laparoscopic ipsilateral ureteroureterostomy was done safely and effectively even in small infants. Postoperative course was uneventful, with negligible blood loss and minimal analgesia requirement, and initial results were comparable to those of open surgery. References 1 : Uretero-ureterostomy: as applied to obstructions of the duplicated urinary tract. J Urol1928; 20: 109. Abstract, Google Scholar 2 : Ipsilateral uretero-ureterostomy for vesicoureteral reflux in duplicated ureter. J Urol1969; 101: 36. Link, Google Scholar 3 : Ipsilateral ureteroureterostomy for vesicoureteral reflux in duplicated ureters. J Urol1977; 118: 826. Link, Google Scholar 4 : The management of children with complete ureteric duplication: selective use of uretero-ureterostomy as a primary and salvage procedure. BJU Int2000; 86: 508. Google Scholar 5 : Ipsilateral ureteroureterostomy for the treatment of vesicoureteral reflux or obstruction associated with complete ureteral duplication. J Urol2001; 165: 552. Link, Google Scholar 6 : Comparison of laparoscopic and open partial nephrectomy for duplication anomalies in children. J Urol2006; 175: 2269. Link, Google Scholar 7 : Reoperative laparoscopic pyeloplasty in children: comparison with open surgery. J Urol2007; 177: 1878. Link, Google Scholar 8 : Experience with the Bailez technique for laparoscopic access in children. J Urol2003; 170: 936. Link, Google Scholar 9 : Ureteroureteral anastomosis in the treatment of reflux associated with ureteral duplication. J Urol1997; 157: 1863. Link, Google Scholar 10 : Is there a best alternative to treating the obstructed upper pole?. J Urol1996; 156: 744. Link, Google Scholar 11 : Ureteroureteric reflux: Pathological entity or physiological phenomenon?. Br J Urol1984; 56: 159. Google Scholar Department of Urology, Thomas Jefferson University, Philadelphia, Pennsylvania, and Division of Urology, Alfred I. duPont Hospital for Children, Wilmington, Delaware© 2007 by American Urological AssociationFiguresReferencesRelatedDetailsCited byPrieto J, Ziada A, Baker L and Snodgrass W (2018) Ureteroureterostomy via Inguinal Incision for Ectopic Ureters and Ureteroceles Without Ipsilateral Lower Pole RefluxJournal of Urology, VOL. 181, NO. 4, (1844-1850), Online publication date: 1-Apr-2009.González R (2018) Editorial CommentJournal of Urology, VOL. 182, NO. 4, (1567-1567), Online publication date: 1-Oct-2009.Neheman A, Noh P, Brenn R and González R (2018) Laparoscopic Urinary Tract Surgery in Infants Weighing 6 kg or Less: Perioperative Considerations and Comparison to Open SurgeryJournal of Urology, VOL. 179, NO. 4, (1534-1538), Online publication date: 1-Apr-2008. Volume 177Issue 6June 2007Page: 2315-2318 Advertisement Copyright & Permissions© 2007 by American Urological AssociationKeywordsurinary incontinencevesico-ureteral refluxlaparoscopyureterureterostomyMetricsAuthor Information Ricardo González More articles by this author Lisandro Piaggio More articles by this author Expand All Advertisement PDF downloadLoading ...