Wang Jinbin,Fang Xiaoliang,Chen Zhoutong,et al.Comparison of single ureteral reimplantation and ipsilateral ureteroureterostomy for ureteral duplication in Children[J].Journal of Clinical Pediatric Surgery,,21():341-346.[doi:10.3760/cma.j.cn101785-202104010-009]
Comparison of single ureteral reimplantation and ipsilateral ureteroureterostomy for ureteral duplication in Children
- Keywords:
- Ureteral Reimplantation; Ureteroureterostomy; Kidney Abnormalities; Ureteral Duplication; Surgical Procedures; Operative/MT; Treatment Outcome
- Abstract:
- ObjectiveTo compare the safety and efficacy of single ureteral bladder replantation versus end-to-side ureteral anastomosis for pediatric duplication of ureteral malformations.MethodsFrom January 2010 to December 2018,retrospective analysis of clinical data was performed for 92 children with duplication of ureteral malformation undergoing single ureteral bladder replantation (n=42) versus end-to-side ureteral anastomosis (n=50).Operative duration,postoperative length of hospitalization,anterioposterior diameter (APD) of renal pelvis,diameter of ureter of affected kidney,renal function of affected kidney and postoperative complications were compared between two groups.ResultsOperative duration of single ureteral bladder replantation group was significantly shorter than that of ureteral end-to-side anastomosis group (Z=-2.28,P=0.023) and number of cases with ureteral stent placement more than that of ureteral end-to-side anastomosis group (χ2=26.799,P<0.0001);no significant inter-group difference existed in average postoperative hospitalization length (Z=-1.639,P=0.101);there were 2 cases of long-term complications[urinary tract infection (n=1),stoma stenosis (n=1)]in single ureter-bladder replantation group and 4 cases of long-term complications in end-to-side ureteral anastomosis group[anastomotic stenosis (n=2),urinary tract infection (n=1),vesicoureteral reflux (n=1)],the difference was not statistically significant (χ2=0.041,P=0.839).APD of renal pelvis,diameter of ureter and renal function of affected kidney improved significantly in two groups before and after operation.No significant inter-group difference existed in changes of anterioposterior renal pelvis diameter ΔAPD(t=0.021,P=0.983) and differential renal function ΔDRF(Z=-1.859,P=0.063) before and after operation.The change value of renal ureter diameter ΔUD was statistically different (t=2.697,P=0.008).ConclusionBoth single ureteral bladder replantation and end-to-side ureteral anastomosis are safe and effective for children with ureteral duplication.End-to-side ureteral anastomosis does not involve bladder and there are fewer catheter-related complications.
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Memo
收稿日期:2021-09-17;改回日期:。
基金项目:国家自然科学基金(81770702)
通讯作者:耿红全,Email:genghongquan@xinhuamed.com.cn