医学
巨输尿管
排尿膀胱尿道造影
外科
膀胱输尿管反流
泌尿系统
无症状的
腹腔镜检查
输尿管镜检查
输尿管
回流
内科学
疾病
作者
Manuel López,Eduardo Perez-Etchepare,Nasser Bustangi,О.S. Godik,Michel Juricic,François Varlet,Rocio Gutierrez,Mario Gomez Culebras,Romy Gander,Gloria Royo,M Asensio
出处
期刊:Journal of Laparoendoscopic & Advanced Surgical Techniques
[Mary Ann Liebert]
日期:2023-07-01
卷期号:33 (7): 713-718
被引量:9
标识
DOI:10.1089/lap.2019.0396
摘要
Introduction: Conservative management of primary obstructive megaureter (POM) appears as the best option in patients with adequate ureteral drainage. Nevertheless, surgical intervention is indicated in cases of recurrent urinary tract Infections (UTIs), deterioration of split renal function, and significant obstruction. The gold standard includes: Ureteral reimplantation with or without tapering by open approach. Our objective is to report our results in the treatment of POM by Laparoscopic-Assisted Extracorporeal Ureteral Tapering Repair (EUTR) and Laparoscopic Ureteral Extravesical Reimplantation (LUER) and to evaluate the efficacy and security of this procedure. Materials and Methods: From January 2011 to January 2018 a retrospective study was carried out by reviewing the clinical records of 26 patients diagnosed with POM. All patients underwent laparoscopic ureteral reimplantation following Lich Gregoir technique. In cases of ureteral tapering, an EUTR was performed with Hendren technique. Results: In all patients LUER and EUTR were performed without conversion. No ureteral tapering was necessary in six patients. There were no intraoperative complications. At 3 months in postoperative, 1 patient presented a febrile UTI, and subsequently, a vesicoureteral reflux (VUR) grade III was diagnosed by voiding cystourethrogram. In this case, a redo laparoscopic surgery was performed. After long-term follow-up, all patients were asymptomatic without recurrence of POM or VUR. Conclusion: Laparoscopic-assisted EUTR and LUER following Lich Gregoir technique for POM constitutes a safe and effective option, with a success rate similar to that of open procedure. Nevertheless, larger randomized prospective trials and long-term follow-up are required to validate this technique.
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