A Novel Modification of Ureteral Reimplantation (Combined Technique) in Pediatric Patients: A Preliminary Case Series.

IF 1 Q4 UROLOGY & NEPHROLOGY
Deniz Demirci, Numan Baydilli, Emrah Kızılay
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引用次数: 0

Abstract

Background: In this video, we present a new open ureteral reimplantation approach (combined technique) with preliminary results from 32 renal units.

Material and methods: Written informed consent was obtained from the parents of the patients. We used a suprapubic Pfannenstiel incision to reach the bladder. After preparation of the ureters with the guidance of the vesicoureteral reflux surgery principle, they were moved from the bladder to the extravesical area. A submucosal tunnel was created above and below the old hiatus with reference to the old hiatus site. The required submucosal tunnel length is adjusted to be 2/3 above the old hiatus and 1/3 below the old hiatus. The ureters were carried down through the submucosal tunnel using a right-angle clamp and fixed to the bladder with 5/0 polyglactin sutures, step by step, respectively.

Results: A total of 22 patients (9 females/13 males) with a median age of 7 (min: 2and max: 15) years were operated on using the combined technique. There were 16 cases with vesicoureteral reflux and 6 cases with unilateral obstructive megaureter. The success rate was found to be 100% for vesicoureteral reflux and 83.3% for primer obstructed megaureter. When we focus on the number of ureters, the overall success rate was found to be 97%.

Conclusion: The vertical angulation or kinking of the ureter at the entrance to the bladder can be prevented in this modification. New orifice localization is close to the normal position. Short tunnel length is out of the question in this modification. We think that with potential surgical advantages, a novel combined technique can be used in ureteral reimplantation.

Abstract Image

一种新的改良输尿管再植(联合技术)在儿科患者:初步病例系列。
背景:在本视频中,我们介绍了一种新的开放输尿管再植入路(联合技术)和32个肾单位的初步结果。材料和方法:获得患者家长的书面知情同意。我们使用耻骨上Pfannenstiel切口到达膀胱。在膀胱输尿管反流手术原理指导下制备输尿管后,将输尿管从膀胱移至膀胱外区域。参考旧裂孔位置,在旧裂孔上方和下方建立粘膜下隧道。所需的粘膜下隧道长度调整为旧裂孔上方2/3,旧裂孔下方1/3。用直角钳将输尿管经粘膜下隧道下行,分别用5/0聚乳酸线与膀胱固定,逐级进行。结果:22例患者(女9例,男13例),中位年龄7岁(最小2岁,最大15岁)。膀胱输尿管反流16例,单侧输尿管梗阻6例。膀胱输尿管反流的成功率为100%,引物梗阻的成功率为83.3%。当我们关注输尿管的数量时,发现总成功率为97%。结论:该方法可防止输尿管在膀胱入口处的垂直成角或扭结。新孔定位接近正常位置。在这次修改中,隧道长度短是不可能的。我们认为一种新颖的联合技术具有潜在的外科优势,可用于输尿管再植。
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来源期刊
Turkish journal of urology
Turkish journal of urology Medicine-Urology
CiteScore
2.10
自引率
0.00%
发文量
53
期刊介绍: The aim of the Turkish Journal of Urology is to contribute to the literature by publishing scientifically high-quality research articles as well as reviews, editorials, letters to the editor and case reports. The journal’s target audience includes, urology specialists, medical specialty fellows and other specialists and practitioners who are interested in the field of urology.
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