Comparison of efficacy between laparoscopic ureteroureterostomy and ureteral reimplantation for the treatment of complete renal and ureteral duplication in children
10.3760/cma.j.cn101070-20240706-00421
- VernacularTitle:腹腔镜输尿管端侧吻合术与输尿管膀胱再植术治疗儿童完全性肾输尿管重复畸形的疗效比较
- Author:
Bin YU
1
;
Luping LI
1
;
Yingzhong FAN
1
Author Information
1. 郑州大学第一附属医院小儿外科，郑州 450052
- Publication Type:Journal Article
- Keywords:
Child;
Laparoscopy;
Ureteroureterostomy;
Ureteral reimplantation;
Duplex kidney
- From:
Chinese Journal of Applied Clinical Pediatrics
2025;40(1):33-38
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the therapeutic value between laparoscopic ureteroureterostomy (LUU) and ureteral reimplantation (UR) for the treatment of pediatric complete renal and ureteral duplication.Methods:This retrospective case-series study included 65 children with complete data, who were diagnosed with complete renal and ureteral duplication at the First Affiliated Hospital of Zhengzhou University from January 2016 to December 2022.Diagnoses were confirmed through preoperative imaging tests, including renal ultrasound, diuretic renography, computed tomography urography, magnetic resonance urography, and voiding cystourethrography.The patients were categorized into 2 groups based on surgical approach.The LUU group had 35 patients, and the UR group had 30 patients.The surgical duration, intraoperative blood loss, the incidence of stent implantation, postoperative length of hospitalization, the upper renal anterioposterior diameter (APD), the upper ureter diameter (UD), and differential renal function (DRF) of the affected kidney before and after surgery were compared between the 2 groups.For continuous variables such as surgery time and intraoperative blood loss that follow a normal distribution, values are expressed as Mean± SD, with between-group differences analyzed using independent t-tests and within-group differences using paired t-tests.For non-normally distributed continuous variables, data are presented as M( Q1, Q3), with group differences assessed by rank-sum tests.Categorical variables like gender and laterality are compared using Chi-square tests. Results:Intraoperative blood loss was significantly different between the LUU and UR groups [(8.5±4.6) mL vs.(12.6±6.4) mL] ( t=2.465, P=0.020).Postoperative length of hospitalization also differed significantly between the 2 groups [(6.4±2.3) days vs.(10.5±2.8) days] ( t=2.308, P=0.027).However, surgical durations of the groups were similar [(143.0±13.2) min vs.(132.0±12.4) min] ( t=-1.965, P=0.057).No significant difference was observed between the two groups [(35/35) cases vs.(26/30) cases] ( χ2=2.932, P=0.087).Four cases in the UR group suffered long-term complications (including anastomotic stricture in 2 cases, vesicoureteral reflux in 1 case, and recurrent urinary tract infection in 1 case).There was 1 case having the long-term complication (which was anastomotic stricture) in the LUU group.The difference in the incidence of long-term complications was not significant between the 2 groups ( χ2=1.239, P=0.266).Both groups showed significant improvements in upper renal APD, UD, and DRF of the affected kidney after surgery.Changes in upper renal APD ( t=-0.032, P=0.962), DRF ( Z=1.895, P=0.073), and UD ( t=1.832, P=0.079) were not statistically significant. Conclusions:Both LUU and UR are safe and effective in the treatment of complete renal and ureteral duplication in children.Compared with UR, LUU has less intraoperative blood loss and shorter postoperative length of hospitalization.LUU does not involve the bladder and causes less damage to the bladder of children.
