Wang Zhaohui,Peng Qianlong,Tian Wen,et al.Comparison of the efficacy of laparoscopic end-to-side ureteroureterostomy and ureteral reimplantation for ureteral duplication in children[J].Journal of Clinical Pediatric Surgery,,():826-831.[doi:10.3760/cma.j.cn101785-20260526-00250]
Comparison of the efficacy of laparoscopic end-to-side ureteroureterostomy and ureteral reimplantation for ureteral duplication in children
- Keywords:
- Child; Ureteral Duplication; Ureteroureterostomy; Ureteral Reimplantation; Surgical Procedures; Operative; Treatment Outcome
- Abstract:
- Objective To compare the safety and efficacy of laparoscopic end-to-side ureteroureterostomy (LUU) and laparoscopic upper-pole ureteral reimplantation (LUR) for the treatment of ureteral duplication in children.Methods The clinical data of 33 children with ureteral duplication who underwent LUU or LUR at Hunan Children’s Hospital from October 2018 to August 2025 were retrospectively analyzed,including 12 patients in the LUU group and 21 patients in the LUR group.The preoperative and postoperative anteroposterior diameter (APD) of the upper-pole renal pelvis and upper-pole ureteral diameter (UD),changes in APD (ΔAPD) and UD (ΔUD) before and after surgery,postoperative length of hospital stay,duration of drainage tube placement,intraoperative blood loss,operative time,and short-and long-term complications were compared between the two groups.Results Postoperative APD of the upper-pole renal pelvis and upper-pole UD were significantly decreased compared with the corresponding preoperative values in both groups (LUU group:Z= -3.061,P=0.002 and Z=-3.064,P=0.002,respectively; LUR group:Z=-4.015,P<0.001 and Z=-3.985,P<0.001,respectively).No statistically significant differences were observed between the two groups in ΔAPD (t=-1.866,P=0.072) or ΔUD (t=-1.054,P=0.300).There were also no statistically significant differences between the two groups in postoperative length of hospital stay or duration of drainage tube placement (Z=-0.784,P=0.433 and Z=-0.323,P=0.747,respectively).Intraoperative blood loss was significantly lower in the LUU group than in the LUR group [15.00 (15.00,18.50) vs.20.00 (19.00, 20.00),Z=-2.854,P=0.004],and operative time was significantly shorter in the LUU group [3.10 (2.80,3.30) vs.3.60 (3.25,4.00),Z=-2.426,P=0.015].The median postoperative follow-up duration was 36.4 months (range,7-77 months).No statistically significant differences were found between the LUU and LUR groups in the incidence of short-term complications (2/12 vs.3/21,χ2=0.034,P=0.094) or long-term complications (0/12 vs.1/21,χ2=0.589,P=0.728).Conclusions Both LUR and LUU are safe and effective surgical procedures for the treatment of ureteral duplication in children.Compared with LUR,LUU is associated with a shorter operative time and less intraoperative blood loss and therefore merits wider clinical application.
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Memo
收稿日期:2026-5-26。
基金项目:湖南省儿童泌尿生殖疾病临床医学研究中心（2021SK4017)
通讯作者:赵夭望,Email:yw508@sina.com