Department of Pediatric Urology, Municipal Hospital 7, Kazachskaya Street 1, Volgograd 400002, Russia.
J Pediatr Urol. 2013 Aug;9(4):437-41. doi: 10.1016/j.jpurol.2013.01.001. Epub 2013 Mar 11.
In contemporary practice the application of a laparoscopic approach for repairing congenital ureterovesical junction obstruction in children is rare. We report our experience with laparoscopic dismembered extravesical transverse ureteral reimplantation in children with unilateral primary ureterovesical junction obstruction.
Ten children (all male, aged 6 months to 5 years) underwent laparoscopic dismembered extravesical transverse ureteral reimplantation. The postoperative follow up included abdomino-pelvic ultrasound at 3 months after surgery, and a voiding cystourethrogram and intravenous urogram at 6 months and 1 year after surgery.
In all patients surgery was completed laparoscopically without conversion to open procedure; there were no major intraoperative complications. The mean operative time was 180 min (range 150-210 min). The postoperative intravenous urogram demonstrated improvement of the dilatation of the pelvicalyceal system and ureters in all patients; in one case grade IV vesicoureteral reflux developed and was successfully treated by endoscopic injection.
We could consider this technique as an eventual option in pediatric minimally invasive urologic surgery. However, larger series with long-term follow up are necessary to validate the results.
在当代实践中，腹腔镜技术应用于治疗儿童先天性输尿管膀胱连接部梗阻较为少见。我们报告了应用腹腔镜离断式外置横形输尿管再植术治疗单侧原发性输尿管膀胱连接部梗阻患儿的经验。
10 例患儿（均为男性，年龄 6 个月至 5 岁）接受了腹腔镜离断式外置横形输尿管再植术。术后随访包括术后 3 个月行腹盆部超声检查，术后 6 个月和 1 年行排尿性膀胱尿道造影和静脉尿路造影。
所有患者均成功完成腹腔镜手术，无中转开放手术；无重大术中并发症。平均手术时间为 180 分钟（范围 150-210 分钟）。术后静脉尿路造影显示所有患者肾盂肾盏系统和输尿管扩张均有改善；1 例出现 4 级膀胱输尿管反流，通过内镜注射成功治疗。
我们可以将该技术视为小儿微创泌尿外科手术的一种选择。然而，需要更大的系列和长期随访来验证结果。
