Zhao Xiang, Tian Qingqing, Fang Erhu, Li Ning
Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Pediatr. 2022 Mar 3;10:834465. doi: 10.3389/fped.2022.834465. eCollection 2022.
Pneumovesicoscopic ureteral reimplantation (PVUR) has gained popularity due to its minimal invasiveness. However, most of the reported PVUR procedures were based on the Cohen technique. Only few studies reported their experience of PVUR using the Politano-Leadbetter technique (PVUR-PL). Here, we reported our experience of PVUR-PL using a novel technique to facilitate locating the retrovesical ureter during the procedure.
The medical records of the patients who underwent PVUR-PL between January 2018 and December 2020 in our institution were retrospectively reviewed. The patients were classified into two groups: the modified group that accepted PVUR-PL using our novel technique (using urethral sound to facilitate identifying the retrovesical ureter) and the traditional group that accepted PVUR-PL not using the novel technique. Clinical data were collected retrospectively.
There were 22 patients who underwent PVUR-PL, with 13 in the traditional group and nine in the modified group. The mean operating time for unilateral cases in the modified group was significantly shorter than that in the traditional group (154.5 vs. 195.5 min, < 0.001). For bilateral cases, the mean operating time was also significantly reduced (from 263.0 to 221.3 min, = 0.022) in the modified group. There were no severe complications in each of the two groups. The peritoneum was perforated in one case from the traditional group, while no peritoneum perforation occurred in the modified group.
The use of urethral sound to help to identify the retrovesical ureter during PVUR-PL is a safe and effective technique. This simple but effective technique could shorten the operating time of PVUR-PL and reduce the risk of peritoneum perforation.
气囊膀胱镜输尿管再植术（PVUR）因其微创性而越来越受欢迎。然而，大多数报道的PVUR手术是基于科恩技术。只有少数研究报告了他们使用波利塔诺-利德贝特技术（PVUR-PL）进行PVUR的经验。在此，我们报告了我们使用一种新技术进行PVUR-PL的经验，该技术有助于在手术过程中定位膀胱后输尿管。
回顾性分析2018年1月至2020年12月在我院接受PVUR-PL治疗的患者的病历。患者分为两组：采用我们的新技术（使用尿道探子辅助识别膀胱后输尿管）接受PVUR-PL的改良组和未使用该新技术接受PVUR-PL的传统组。回顾性收集临床资料。
22例患者接受了PVUR-PL，其中传统组13例，改良组9例。改良组单侧病例的平均手术时间明显短于传统组（154.5对195.5分钟，<0.001）。对于双侧病例，改良组的平均手术时间也显著缩短（从263.0分钟降至221.3分钟，=0.022）。两组均未出现严重并发症。传统组有1例发生腹膜穿孔，而改良组未发生腹膜穿孔。
在PVUR-PL过程中使用尿道探子帮助识别膀胱后输尿管是一种安全有效的技术。这种简单但有效的技术可以缩短PVUR-PL的手术时间，降低腹膜穿孔的风险。
