Hakan Bahadir Haberal, Beatriz Bañuelos Marco, Muhammet Irfan Donmez, Alessio Pecoraro, Alberto Piana, Thomas Prudhomme, Alicia López-Abad, Alberto Breda, Angelo Territo
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引用次数: 0
Abstract
Objectives: Ureteral obstruction, vesicoureteral reflux (VUR), and urine leak constitute the most common urological complications following pediatric kidney transplantation (KT). Redo ureteroneocystostomy (UNC) is one of the methods used in the treatment of these complications. This study aims to systematically review the available evidence regarding the success and complications associated with redo UNC in pediatric KT recipients.
Methods: This systematic review (SR) focused on studies examining the success and complications of redo UNC in pediatric KT recipients, limited to English-language publications. The SR was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines with the searches encompassing databases of Web of Science, PubMed, and Scopus.
Results: After screening 253 abstracts, nine studies with a total of 78 patients were included. The most common indication for redo UNC was VUR (50/78, 64.1%), followed by obstruction (19/78, 24.4%), urine leak (5/78, 6.4%), urinary fistula (3/78, 3.8%), and ureteral necrosis (1/78, 1.3%). The extravesical method was used in 15 patients, with the modified Lich-Gregoir technique being the most frequent. The intravesical approach, most commonly the Cohen technique, was used in 14 patients. The average success rate for redo UNC was 91.4%. Postoperative complications included urinary tract infections and urinary obstruction.
Conclusion: Based on currently limited available data, redo UNC is an effective and safe option for pediatric KT recipients with ureteral complications.
目的：输尿管梗阻、膀胱输尿管反流（VUR）和尿漏是儿童肾移植（KT）后最常见的泌尿系统并发症。输尿管膀胱造瘘术（UNC）是治疗这些并发症的方法之一。本研究的目的是系统地回顾关于儿童KT受者重做UNC的成功和并发症的现有证据。方法：本系统综述（SR）集中研究了儿童KT受者重做UNC的成功和并发症，仅限于英语出版物。SR是按照系统评价和元分析的首选报告项目指南进行的，包括Web of Science、PubMed和Scopus数据库的搜索。结果：在筛选了253篇摘要后，纳入了9项研究，共78例患者。重做UNC最常见的指征是VUR(50/78, 64.1%)，其次是梗阻（19/78,24.4%）、尿漏（5/78,6.4%）、尿瘘（3/78,3.8%）和输尿管坏死（1/78,1.3%）。15例患者采用体外方法，其中以改良的Lich-Gregoir技术最为常见。14例患者采用膀胱内入路，最常见的是Cohen技术。重做UNC的平均成功率为91.4%。术后并发症包括尿路感染和尿路梗阻。结论：基于目前有限的可用数据，重做UNC对于输尿管并发症的儿童KT受体是一种有效且安全的选择。试验注册：PROSPERO: CRD42024592989。
期刊介绍：
International Journal of Urology is the official English language journal of the Japanese Urological Association, publishing articles of scientific excellence in urology. Submissions of papers from all countries are considered for publication. All manuscripts are subject to peer review and are judged on the basis of their contribution of original data and ideas or interpretation.
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