Pediatric Surgery Department, The First Affiliated Hospital of Guangxi Medical University, Nanning, PR China.
J Endourol. 2022 Aug;36(8):1043-1049. doi: 10.1089/end.2021.0309. Epub 2022 May 2.
There are many reports on the application of minimally invasive technology in correction of children's vesicoureteral junction obstruction (VUJO), but there is no report on the treatment of children's VUJO with the transumbilical laparoendoscopic single-site surgery (TU-LESS) Lich-Gregoir method. We aimed to comparatively analyze the therapeutic outcomes of transvesicoscopic ureteral reimplantation Cohen (TUR-C) procedure and TU-LESS Lich-Gregoir (TU-LESS-LG) procedure in pediatric VUJO. The data of 49 children with VUJO, admitted from January 2016 to January 2020, were retrospectively analyzed. Based on different surgical methods, they were divided into the TUR-C group (23 cases) and the TU-LESS-LG group (26 cases). Demographic characteristics, perioperative characteristics, postoperative complications, recovery of renal function, and improvement of hydronephrosis were compared between the two groups. There were no statistical differences in demographic characteristics and preoperative data between the two groups. The TU-LESS-LG group was superior to the TUR-C group in terms of average operation time and postoperative hospital stay. There was no statistical difference between the two groups in terms of postoperative complications, postoperative recovery of renal function, and improvement of hydronephrosis. The two surgical methods can achieve a similar curative effect in the treatment of VUJO. The TU-LESS-LG procedure has more advantages of operation time, postoperative hospital stay, wider age range for selection of cases, megaureter tapering, and cosmetic incision, but the operation is more difficult. Clinical Trial Registration number: 2021(KY-E-048).
有许多关于微创技术在儿童肾盂输尿管连接部梗阻(VUJO)矫正中应用的报道,但尚无经脐腹腔镜单部位手术(TU-LESS)Lich-Gregoir 方法治疗儿童 VUJO 的报道。我们旨在比较分析经膀胱输尿管再植术 Cohen(TUR-C)和 TU-LESS Lich-Gregoir(TU-LESS-LG)在小儿 VUJO 中的治疗效果。回顾性分析 2016 年 1 月至 2020 年 1 月收治的 49 例 VUJO 患儿的临床资料。根据不同的手术方法,将患儿分为 TUR-C 组(23 例)和 TU-LESS-LG 组(26 例)。比较两组患儿的一般资料、围手术期情况、术后并发症、肾功能恢复情况及肾积水改善情况。两组患儿的一般资料及术前资料比较,差异无统计学意义。TU-LESS-LG 组的平均手术时间和术后住院时间均优于 TUR-C 组。两组术后并发症、术后肾功能恢复情况及肾积水改善情况比较,差异无统计学意义。两种手术方法在治疗 VUJO 方面均能取得相似的疗效。与 TUR-C 组相比,TU-LESS-LG 组在手术时间、术后住院时间、病例选择年龄范围、巨输尿管变细、美容切口等方面具有更多优势,但操作难度更大。临床试验注册号:2021(KY-E-048)。