Top

Pediatric Surgery International

Published in:

Open Access 01-12-2023 | Laparoscopy | Original Article

Long-term, single-center study comparing open and laparoscopic procedures for congenital midureteral obstruction in children

Authors: Guanglun Zhou, Man Jiang, Jianchun Yin, Xiaodong Liu, Junjie Sun, Shoulin Li

Published in: Pediatric Surgery International | Issue 1/2023

Abstract

Purpose

To compare the safety and outcomes of open and laparoscopic procedures in the management of congenital midureteral obstruction in children (CMO).

Methods

Between February 2008 and February 2022, a total of 18 patients underwent open ureteroureterostomy (OU group), and 26 underwent laparoscopic ureteroureterostomy (LU group). The operative time, postoperative hospital stay, hospital costs, postoperative complications, and success rates of the two groups were compared.

Results

The median age of the patients was 59 months, with 29 patients presenting with asymptomatic hydronephrosis, 12 with intermittent abdominal pain, and 3 with flank mass. The median follow-up time was 42 months, and all patients were successfully treated surgically. The operative time and postoperative hospital stay in the LU group were shorter than those in the OU group (106.3 ± 21.4 vs. 85.8 ± 16.5 min, 11.6 ± 1.9 vs. 8.3 ± 1.7 days, respectively; p < 0.05). The OU group had two postoperative complications, both of which were classified as Clavien–Dindo grade II based on the Clavien–Dindo classification. One case of postoperative complication occurred in the LU group, which was classified as Clavien–Dindo Grade II. There was no significant statistical difference in complications between the two groups (P > 0.05).

Conclusions

Our data showed that laparoscopic ureteroureterostomy is a safe and effective treatment for congenital midureteral obstruction in children, and provides several advantages, including fewer postoperative complications, shorter postoperative hospital stay, and a shorter operative time. Laparoscopic procedures should be the first choice for treating children with congenital midureteral obstructions.

Lu LS, Bi YL, Wang X, Ruan SS (2017) Laparoscopic resection and end-to-end ureteroureterostomy for midureteral obstruction in children[J]. J Laparoendosc Adv Surg Tech A 27(2):197–202. https://doi.org/10.1089/lap.2016.0222CrossRefPubMed

Chandrasekharam VVS (2015) Laparoscopic repair of congenital midureteric strictures in infants and children. J Pediatr Surg 50(11):1909–1913. https://doi.org/10.1016/j.jpedsurg.2015.07.013CrossRefPubMed

Tyritzis SI, Wiklund NP (2015) Ureteral strictures revisited…trying to see the light at the end of the tunnel: a comprehensive review. J Endourol 29(2):124–136. https://doi.org/10.1089/end.2014.0522CrossRefPubMed

Kannaiyan L, Karl S, Mathai J, Chacko J, Sen S (2009) Congenital ureteric stenosis: a study of 17 children. Pediatr Surg Int 25(6):513–517. https://doi.org/10.1007/s00383-009-2368-0CrossRefPubMed

Hwang AH, Mcaleer IM, Shapiro E, Miller OF, Krous HF, Kaplan GW (2005) Congenital mid ureteral strictures. J Urol 174(5):1999–2002. https://doi.org/10.1097/01.ju.0000176462.56473.0cCrossRefPubMed

Meng Z, Lin D, Wang G, Qu YC, Sun N (2021) Congenital midureteral stenosis in children: a 13-year retrospective study based on data from a large pediatric medical center. BMC Urol 21(1):152. https://doi.org/10.1186/s12894-021-00916-2CrossRefPubMedPubMedCentral

Nezhat C, Nezhat F, Green B (1992) Laparoscopic treatment of obstructed ureter due to endometriosis by resection and ureteroureterostomy: a case report. J Urol 148(3):865–868. https://doi.org/10.1016/s0022-5347(17)36747-2CrossRefPubMed

Nezhat CH, Nezhat F, Seidman D, Nezhat C (1998) Laparoscopic ureteroureterostomy: a prospective follow-up of 9 patients. Prim Care Update Ob Gyns 5(4):200. https://doi.org/10.1016/s1068-607x(98)00136-xCrossRefPubMed

Hostiuc S, Rusu MC, Negoi I, Grigoriu M, Hostiuc M (2019) Retrocaval ureter: a meta-analysis of prevalence. Surg Radiol Anat. https://doi.org/10.1007/s00276-019-02269-wCrossRefPubMed

10.

Tamhankar AS, Savalia AJ, Sawant AS, Pawar PW, Kasat GV, Patil SR (2017) Transperitoneal laparoscopic repair of retrocaval ureter: our experience and review of literature. Urol Ann 9(4):324–329. https://doi.org/10.4103/UA.UA_52_17CrossRefPubMedPubMedCentral

11.

Arlen AM, Kirsch AJ, Cuda SP, Little SB, Jones RA, Grattan-Smith JD, Cerwinka WH (2014) Magnetic resonance urography for diagnosis of pediatric ureteral stricture. J Pediatr Urol 10(5):792–798. https://doi.org/10.1016/j.jpurol.2014.01.004CrossRefPubMed

12.

Smith BG, Metwalli AR, Leach J, Cheng EY, Kropp BP (2004) Congenital midureteral stricture in children diagnosed with antenatal hydronephrosis. Urology 64(5):1014–1019. https://doi.org/10.1016/j.urology.2004.06.015CrossRefPubMed

13.

Bhandarkar DS, Lalmalani JG, Shivde S (2003) Laparoscopic ureterolysis and reconstruction of a retrocaval ureter. Surg Endosc 17(11):1851–1852. https://doi.org/10.1007/s00464-003-4513-5CrossRefPubMed

14.

Li HZ, Ma L, Qi L, Shi TP, Wang BJ, Zhang X (2010) Retroperitoneal laparoscopic ureteroureterostomy for retrocaval ureter: report of 10 cases and literature review. Urology 76(4):873–876. https://doi.org/10.1016/j.urology.2009.12.056CrossRefPubMed

15.

Chen Z, Chen X, Wu ZH, Luo YC, Li NN (2011) Treatment of retrocaval ureter by retroperitoneal laparoscopic ureteroureterostomy: experience on 12 patients. J Laparoendosc Adv Surg Tech A 21(9):803–807. https://doi.org/10.1089/lap.2011.0211CrossRefPubMed

Title: Long-term, single-center study comparing open and laparoscopic procedures for congenital midureteral obstruction in children
Authors: Guanglun Zhou
Man Jiang
Jianchun Yin
Xiaodong Liu
Junjie Sun
Shoulin Li
Publication date: 01-12-2023
Publisher: Springer Berlin Heidelberg
Keyword: Laparoscopy
Published in: Pediatric Surgery International / Issue 1/2023
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-023-05494-y

At a glance: The STEP trials

Springer Medicine

Long-term, single-center study comparing open and laparoscopic procedures for congenital midureteral obstruction in children

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2023

Testicular descent revisited: a micro-computed tomography study in fetal rats

Nephron sparing surgery outcomes in Wilms’ tumor: is it ready for primetime?

Letter to the Editor: Comment on Wickramasekara N, Ignatius J, Lamahewage A. Prognostic factors and outcomes of Kasai portoenterostomy (KPE): nine-year experience from a lower-middle income country. Pediatr Surg Int. 2023; 39(1):142. doi: 10.1007/s00383-023–05,424-y

Thoracoscopic vs open repair of congenital diaphragmatic hernia after extracorporeal membrane oxygenation: a comparison of intra-operative data

Discriminatory capacity of serum total bilirubin between complicated and uncomplicated acute appendicitis in children: a systematic review and a diagnostic test accuracy meta-analysis

Robot-assisted laparoscopic varicocelectomy in a pediatric population