Efficacy of Ureteral Dilation Versus Ureteral Reimplantation for Primary Obstructed Megaureter in Children
10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2025.0415
- VernacularTitle:输尿管扩张术和输尿管膀胱再植术治疗儿童原发性巨输尿管症疗效分析
- Author:
Jiabin JIANG
1
;
Yin ZHANG
1
;
Ye ZHANG
1
;
Xiang FANG
1
;
Daolong LI
1
;
Peng TANG
1
;
Tengyun LONG
1
;
Min CHAO
1
Author Information
1. 安徽省儿童医院泌尿外科,安徽 合肥 230051
- Publication Type:Journal Article
- Keywords:
ureteral stricture;
surgical treatment;
ureteral dilation;
ureteral reimplantation;
children
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2025;46(4):686-692
- CountryChina
- Language:Chinese
-
Abstract:
[Objective]To evaluate the efficacy of ureteral dilation versus ureteral reimplantation in treating pediatric primary obstructive megaureter(POM).[Methods]A retrospective analysis was conducted on clinical data of 53 pediatric patients with POM treated in the Department of Urology,Anhui Provincial Children's Hospital from April 2019 to September 2023.The cohort included 37 boys and 16 girls with 5 bilateral and 48 unilateral cases.The age ranged from 1 to 157 months,with a median age of 17.00(5.50-48.00)months.Patients were assigned to 3 groups based on the management of the ureteral stricture segment:dilation group(18 cases,19 sides),Cohen group(20 cases,24 sides),and Lich-Gregoir group(15 cases,15 sides).The duration of the operations,postoperative hospital stays,postoperative indwelling catheters,postoperative D-J stents;changes in renal pelvis anteroposterior diameter and ureteral diameter;and postoperative complications were compared to evaluate the therapeutic effects.[Results]All 53 patients successfully underwent surgery.The dilation group showed significantly shorter operative time,postoperative hospital stay,and postoperative catheterization duration compared to the Cohen and Lich-Gregoir groups(P＜0.05).However,the postoperative D-J stent time was longer in the dilation group than in the other 2 groups(P＜0.05).Upon follow-ups for 6-12 months after stent removal,all groups demonstrated statistically significant reductions in renal pelvis anteroposterior diameter and ureteral diameter compared to preoperative values(P＜0.05).No significant differences were observed among the 3 groups in hydronephrosis resolution rates(P＞0.05).Additionally,the incidence of postoperative complications(urinary tract infection,vesicoureteral reflux,and reoperation for restenosis)did not differ significantly among the groups(P＞0.05).[Conclusions]Ureteral dilation demonstrated non-inferior short-term clinical efficacy compared to ureteral reimplantation in managing POM in pediatric patients.With reduced operative time,minimal invasiveness,and technical simplicity,ureteral dilation may be considered a preferential treatment option for children with POM.
