Laparoscopic ureteral reimplantation with extracorporeal tailoring and direct nipple ureteroneocystostomy for adult obstructive megaureter: long-term outcomes and comparison to open procedure

Zhong, Weiguo; Yao, Lin; Cui, Henggang; Yang, Kun‐Lin; Wang, Gang; Xu, Tao; Ye, Xiongjun; Li, Xuesong; Zhou, Liqun

doi:10.1007/s11255-017-1687-7

Cited by 10 publications

(4 citation statements)

References 22 publications

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“…For adult cases, inspired by the anti-reflux nipple technique openly for the treatment of megaureters, our institute modified the LUR with extracorporeal tailoring and direct nipple ureteroneocystostomy, where the distal end was tailored and formed into an anti-reflux nipple extracorporeally and the ureteral nipple was intracorporeally reimplanted into the posterolateral wall of the bladder ( 33 ). In comparison with the open group, this technique resulted in less estimated blood loss, less narcotic analgesic, and shorter hospital stay, with no significantly different long-term outcomes including rates of recurrent ureteral stricture, rates of vesicoureteral reflux (VUR), and success rates ( 6 ).…”

Section: Resultsmentioning

confidence: 99%

“…Open ureteral reimplantation (OUR) has shown an excellent success rate of nearly 90% and remained the gold standard treatment for symptomatic obstructive megaureter ( 3 , 5 , 6 ). Ureteral reimplantation is to excise the narrow ureteral segment with or without tailoring the ureter to the appropriate size by tapering or plication and to anastomose the distal ureter to the bladder with an anti-reflux submucosal tunnel or ureteral nipple ( 5 , 7 ).…”

Section: Introductionmentioning

confidence: 99%

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Minimally invasive ureteral reimplantation or endoscopic management for primary obstructive megaureter: a narrative review of technical modifications and clinical outcomes

Yang

et al. 2022

Transl Androl Urol

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Background and Objective: Primary obstructive megaureter (POM) has various courses in different age populations. Although open ureteral reimplantation (OUR) remains the standard treatment for symptomatic POM, it is highly invasive with potential complications. In recent years, minimally invasive ureteral reimplantation (MIUR), including laparoscopic ureteral reimplantation (LUR) and roboticassisted laparoscopic ureteral reimplantation (RALUR), and endoscopic management, such as double-J stent insertion, endoureterotomy and endoscopic balloon dilatation (EBD), have been utilized for POM in selected patients. However, few comparable studies between MIUR and endoscopic management have been published to date, and it remains unclear which surgical management is the optimal choice for POM in different age groups. This review provides a comprehensive perspective on technical development and clinical outcomes of MIUR and endoscopic management for POM in pediatric and adult populations. Methods:The PubMed and Web of Science databases were used to comprehensively search English language articles related to MIUR and endoscopic management for POM in pediatric and adult populations up to March 2022. The technical modifications and the relevant clinical outcomes were reviewed. Key Content and Findings: MIUR with various technical modifications related to intracorporealsuturing and ureteroneocystostomy with anti-reflux techniques appears to be as safe and effective for POM in different age groups as the open procedure. Double-J stent insertion should be regarded as a temporary option for infants by achieving internal urinary drainage, as it may present limited success rates and various complications. Endoureterotomy using pure cutting current or laser appears to be a safer, easier, and less invasive alternative to open surgical management. While EBD has emerged as a definite treatment for POM in the pediatric population, it is debatable whether EBD can substitute for MIUR in adult patients. Conclusions:The safety and feasibility of MIUR and endoscopic management in patients from all age groups still need further investigation.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Minimally invasive ureteral reimplantation or endoscopic management for primary obstructive megaureter: a narrative review of technical modifications and clinical outcomes

Yang

et al. 2022

Transl Androl Urol

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“…The above reconstruction techniques are detailed in previous reports. [18] The RP procedures were performed via the extraperitoneal or the intraperitoneal approach. For extraperitoneal RP, the patient was placed in the Trendelenburg position, and five ports were placed with one for the robotic camera, two for the robotic arms and two for the assistant.…”

Section: Surgical Techniquementioning

confidence: 99%

Robotic urologic surgery using the KangDuo-Surgical Robot-01 system: A single-center prospective analysis

Xiong,

Fan,

Chen

et al. 2023

Chin Med J

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Background: The KangDuo-Surgical Robot-01 (KD-SR-01) system is a new surgical robot recently developed in China. The aim of this study was to present our single-center experience and mid-term outcomes of urological procedures using the KD-SR-01 system. Methods: From August 2020 to April 2023, consecutive urologic procedures were performed at Peking University First Hospital using the KD-SR-01 system. The clinical features, perioperative data, and follow-up outcomes were prospectively collected and analyzed. Results: A total of 110 consecutive patients were recruited. Among these patients, 28 underwent partial nephrectomy (PN), 41 underwent urinary tract reconstruction (26 underwent pyeloplasty, 3 underwent ureteral reconstruction and 12 underwent ureterovesical reimplantation [UR]), and 41 underwent radical prostatectomy (RP). The median operative time for PN was 112.5 min, 157.0 min for pyeloplasty, 151.0 min for ureteral reconstruction, 142.5 min for UR, and 138.0 min for RP. The median intraoperative blood loss was 10 mL for PN, 10 mL for pyeloplasty, 30 mL for ureteral reconstruction, 20 mL for UR, and 50 mL for RP. All procedures were successfully completed without conversion, and there were no major complications in any patient. The median warm ischemia time of PN was 17.3 min, and positive surgical margin was not noted in any patient. The overall positive surgical margin rate of RP was 39% (16/41), and no biochemical recurrence was observed in any RP patient during the median follow-up of 11.0 months. The surgical success rates of pyeloplasty and UR were 96% (25/26) and 92% (11/12) during the median follow-up of 29.5 months and 11.5 months, respectively. Conclusion: The KD-SR-01 system appears feasible, safe, and effective for most urological procedures, based on our single-center experience.

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“…With the incorporation of new technical advances, the laparoscopic vesico-ureteral reimplantation has been gradually incorporated into the management of patients with duplex kidney abnormalities. Conventional vesico-ureteral reimplantation can be divided into three categories: extra-vesical, intravesical and union of Intra-and extra-vesical approaches (10). Among various intra-vesical approaches, Cohen and Politano-Leadbetter methods are the most widely accepted and applied in clinical practice (11,12).…”

Section: Original Articlementioning

confidence: 99%

Lich-Gregoir vesico-ureteral reimplantation for duplex kidney anomalies in the pediatric population: a retrospective cohort study between laparoscopic and open surgery

Zhu¹,

Wang²,

Zhu³

et al. 2021

Transl Pediatr

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Background: The aim of the study is to compare the Lich-Gregoir vesico-ureteral reimplantation in laparoscopy and open surgery.Methods: In this case control study, we enrolled pediatric patients who were diagnosed with unilateral duplex kidney and had underwent surgical treatment. The surgical treatments were either conventional open surgery or laparoscopic surgery. We collected the basic demographic data and extracted the operativerelated statistics such as operation time, blood loss, length of hospital stay, pain level, and post-operative complications. The two groups were compared using Student's t-test.Results: A total of 90 subjects were enrolled. Of the enrolled subjects, 35 underwent open surgery and 55 underwent laparoscopic surgery. There were no observable difference in the basic demographics between two groups (P>0.05). The duration of operation in laparoscopic surgery group was significantly shorter than in the open surgery group (95.60±5.25 vs. 108.70±3.12 min, P=0.040). It was also noted that the amount of blood loss, length of hospital stay, drainage level, and the mean visual analog scale in laparoscopic group were significantly lower (P<0.05). The total incidence of complications in the laparoscopic and open surgery groups were 16.36% and 37.14%, respectively.Conclusions: Laparoscopic Lich-Gregoir vesico-ureteral reimplantation surgery management can be successful, clinically effective, and safe for pediatric population with functional duplex kidneys, and is better than the open surgery techniques.

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Laparoscopic ureteral reimplantation with extracorporeal tailoring and direct nipple ureteroneocystostomy for adult obstructive megaureter: long-term outcomes and comparison to open procedure

Abstract: Laparoscopic ureteral reimplantation with extracorporeal tailoring and direct nipple ureteroneocystostomy is a safe and equally effective as the open surgery for the long-term outcomes of adult obstructive megaureter.

Cited by 10 publications

References 22 publications

Minimally invasive ureteral reimplantation or endoscopic management for primary obstructive megaureter: a narrative review of technical modifications and clinical outcomes

Minimally invasive ureteral reimplantation or endoscopic management for primary obstructive megaureter: a narrative review of technical modifications and clinical outcomes

Robotic urologic surgery using the KangDuo-Surgical Robot-01 system: A single-center prospective analysis

Lich-Gregoir vesico-ureteral reimplantation for duplex kidney anomalies in the pediatric population: a retrospective cohort study between laparoscopic and open surgery

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