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

Abstract

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.

Minimally Invasive versus Open Ureteral Reimplantation in Children: A Systematic Review and Meta-Analysis

“…Blood loss was reported in five studies. 10,14,[17][18][19] Metaanalysis demonstrated a statistically significant decrease in blood loss for MIS compared with OUR while the statistical heterogeneity was evident (I 2 ¼ 100%, WMD -12.65, 95% CI -24.82 to -0.48; p ¼ 0.04; ►Fig. 3).…”

“…Eleven comparative studies were conducted to compare the effectiveness of MIS and OUR. [10][11][12][13][14][15][17][18][19]21,22 The results of the meta-analysis showed that no significant difference was found in the success rate between the two groups (OR 1.13, 95% CI 0.43-2.99, p ¼ 0.80) without heterogeneity (I 2 ¼ 0%, OR 1.31, 95% CI 0.79-2.17; p ¼ 0.30; ►Fig. 5).…”

“…Postoperative UTI was observed in 12 studies. [10][11][12][13][14][16][17][18][19][21][22][23] There were 40 UTI cases (2.1%) in the OUR group and 47 cases (7.9%) in the MIS group. There was no statistically significant difference between the MIS and OUR groups (I 2 ¼ 0%, OR 1.16, 95% CI 0.71-1.89; p ¼ 0.55; ►Fig.…”

“…Six studies 10,11,13,14,18,23 reported postoperative hematuria. There were 4 (1.0%) cases of postoperative hematuria in the MIS group and 26 (1.5%) in the OUR group.…”

“…Twelve studies included operational time data, and nine of them were eligible for meta-analysis. [10][11][12][13][14][15][16][17][18] Meta-analysis show that no statistically significant difference was found between the MIS and OUR group with obvious statistical heterogeneity (I 2 ¼ 98%, WMD 20.73, 95% confidence interval [CI] -2.64 to 44.09; p ¼ 0.08; ►Fig. 2).…”