Vesicoscopic ureteral reimplantation with a modified Glenn-Anderson technique for vesicoureteral reflux. 2023

Morihiro Nishi, and Rumiko Eura, and Chihiro Hayashi, and Ayako Gohbara, and Yuichiro Yamazaki
Department of Urology, Kanagawa Children's Medical Center, 2-138-4 Mutsukawa, Minami-ku, Yokohama 232-8555, Japan. Electronic address: uromori2000@yahoo.co.jp.

Vesicoureteral reflux (VUR), commonly referred to as urinary reflux, is one of the most common congenital urological anomaly to occur during childhood. Historically, open vesicoureteral reimplantation has been the gold standard in the surgical treatment of VUR. Currently, vesicoscopic ureteral reimplantation is used as a minimally invasive alternative to open ureteral reimplantation. Most vesicoscopic procedures are performed using the transtrigonal Cohen technique. As a non-transtrigonal technique, the vesicoscopic Politano-Leadbetter technique is also performed, but requires dissection outside the bladder under a narrow surgical field, and in boy carries a risk of vas deferens injury. This study evaluated surgical outcomes and perioperative findings for vesicoscopic ureteral reimplantation using a modified Glenn-Anderson technique in children with VUR. Eighteen consecutive children who underwent vesicoureteral ureteral reimplantation using a modified Glenn-Anderson technique were included in this study. The surgical procedure was explained and surgical outcomes and perioperative findings were evaluated. Patients comprised 9 boys and 9 girls with 29 cases of ureteral reflux (7 unilateral cases, 11 bilateral cases). All procedures were performed laparoscopically, with no cases requiring conversion to open surgery. Median operative time was 143 min for unilateral VUR and 194 min for bilateral VUR. Only one case showed a complication (Clavien-Dindo grade 1). The remaining 17 cases showed no complications, with removal of the urethral catheter and discharge 2 days postoperatively. Seventeen of the 18 cases underwent postoperative voiding cystourethrography, showing no VUR in all cases. Vesicoscopic ureteral reimplantation is a minimally invasive alternative to open surgery, with most procedures performed using a transtrigonal Cohen technique. Regardless of whether the surgery is open or laparoscopic, a disadvantage of the Cohen technique is that postoperative transureteral treatment may not be possible. The Politano-Leadbetter technique has been reported as a non-transtrigonal technique. However, this requires dissection outside the bladder under a narrow surgical field, and carries a risk of vas deferens injury in boys. In this study, vesicoscopic ureteral reimplantation using a modified Glenn-Anderson technique provided good surgical outcomes with minimal perioperative complications and easy manipulation under a wide field of view. Although many minimally invasive treatments are available, vesicoscopic ureteral reimplantation using a modified Glenn-Anderson technique is safe and effective for patients with VUR 4 years old. To demonstrate the further utility of this procedure, long-term outcomes and safety evaluations are needed in a larger number of cases.

UI MeSH Term Description Entries
D008297 Male Males
D012092 Replantation Restoration of an organ or other structure to its original site. Reimplantation,Surgical Replantation,Replantation, Surgical,Reimplantations,Replantations,Replantations, Surgical,Surgical Replantations
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D013520 Urologic Surgical Procedures Surgery performed on the urinary tract or its parts in the male or female. For surgery of the male genitalia, UROLOGIC SURGICAL PROCEDURES, MALE is available. Procedure, Urologic Surgical,Procedures, Urologic Surgical,Surgical Procedure, Urologic,Surgical Procedures, Urologic,Urologic Surgical Procedure,Urological Surgical Procedures,Procedure, Urological Surgical,Procedures, Urological Surgical,Surgical Procedure, Urological,Surgical Procedures, Urological,Urological Surgical Procedure
D014513 Ureter One of a pair of thick-walled tubes that transports urine from the KIDNEY PELVIS to the URINARY BLADDER. Ureters
D014718 Vesico-Ureteral Reflux Retrograde flow of urine from the URINARY BLADDER into the URETER. This is often due to incompetence of the vesicoureteral valve. Primary Vesicoureteral Reflux,Secondary Vesicoureteral Reflux,Vesicoureteral Reflux Grade1,Vesicoureteral Reflux1,Vesicoureteral Reflux,Vesicoureteral Reflux 1,Grade1, Vesicoureteral Reflux,Reflux, Primary Vesicoureteral,Reflux, Secondary Vesicoureteral,Reflux, Vesico-Ureteral,Reflux, Vesicoureteral,Reflux1, Vesicoureteral,Vesico Ureteral Reflux,Vesicoureteral Reflux, Primary,Vesicoureteral Reflux, Secondary,Vesicoureteral Reflux1s

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