Transabdominal approach laparoscopic ureteral reimplantation at the top of the bladder for the treatment of primary obstructive megaureter
BackgroundCongenital primary obstructive megaureter (POM) is characterized by distal ureteral obstruction, leading to ureteral dilation, hydronephrosis, and potential renal impairment. Surgical intervention is necessary for severe hydronephrosis (SFU grade III–IV) or progressive renal decline. Open...
Saved in:
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-04-01
|
| Series: | Frontiers in Pediatrics |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2025.1552433/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849701600198656000 |
|---|---|
| author | Xianhui Shang Xianhui Shang Zhen Luo Zhen Luo Yingbo Li Yingbo Li Guangxu Zhou Guangxu Zhou Yuchen Mao Yuchen Mao Hongyang Tan Hongyang Tan Kaiyi Mao Kaiyi Mao Peng Zhao Peng Zhao Cao Wang Cao Wang Zhu Jin Zhu Jin Yuanmei Liu Yuanmei Liu |
| author_facet | Xianhui Shang Xianhui Shang Zhen Luo Zhen Luo Yingbo Li Yingbo Li Guangxu Zhou Guangxu Zhou Yuchen Mao Yuchen Mao Hongyang Tan Hongyang Tan Kaiyi Mao Kaiyi Mao Peng Zhao Peng Zhao Cao Wang Cao Wang Zhu Jin Zhu Jin Yuanmei Liu Yuanmei Liu |
| author_sort | Xianhui Shang |
| collection | DOAJ |
| description | BackgroundCongenital primary obstructive megaureter (POM) is characterized by distal ureteral obstruction, leading to ureteral dilation, hydronephrosis, and potential renal impairment. Surgical intervention is necessary for severe hydronephrosis (SFU grade III–IV) or progressive renal decline. Open ureteral reimplantation is the standard treatment but is associated with significant surgical trauma and prolonged recovery. This study evaluates the safety and efficacy of transabdominal laparoscopic ureteral reimplantation (TALUR) at the posterior wall-bladder dome and compares its outcomes with the Politano procedure.MethodsThis retrospective, single-center study included pediatric POM patients who underwent ureteral reimplantation at the Affiliated Hospital of Zunyi Medical University from October 2019 to December 2023. Patients were assigned to the TALUR group (n = 21) or the Politano group (n = 20). Preoperative imaging, including renal ultrasound, magnetic resonance urography (MRU), and voiding cystourethrography (VCUG), confirmed the diagnosis. Primary endpoints included postoperative distal ureteral diameter, renal pelvic diameter, surgical success rate, perioperative complications, hospital stay, and vesicoureteral reflux (VUR) incidence. Follow-up assessments included ultrasound, MRU, and VCUG.ResultsAll procedures were successfully completed without conversion to open surgery. The TALUR group had a significantly shorter operative time (76.5 ± 12.6 min) compared to the Politano group (95.7 ± 14.8 min, P < 0.05). Postoperatively, distal ureteral diameter decreased from 14.6 ± 3.7 mm–4.8 ± 2.1 mm (P < 0.05), and renal pelvic dilation improved from 24.7 ± 5.3 mm–12.3 ± 2.6 mm (P < 0.05). The TALUR group had a shorter hospital stay (4.5 ± 0.5 vs. 6.1 ± 0.7 days, P < 0.05). Follow-up MRU showed improved ureteral patency and resolution of hydronephrosis. VCUG at six months showed mild VUR in two TALUR patients (9.5%) and one Politano patient (5.0%), all resolving within one year.ConclusionTALUR is a safe and effective minimally invasive technique for pediatric POM. Compared to the Politano procedure, TALUR offers shorter operative time, faster recovery, and comparable efficacy. Further large-scale studies are required to confirm its long-term effectiveness. |
| format | Article |
| id | doaj-art-6bc2cd30f38d49d999213a6c018f38e4 |
| institution | DOAJ |
| issn | 2296-2360 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj-art-6bc2cd30f38d49d999213a6c018f38e42025-08-20T03:17:54ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-04-011310.3389/fped.2025.15524331552433Transabdominal approach laparoscopic ureteral reimplantation at the top of the bladder for the treatment of primary obstructive megaureterXianhui Shang0Xianhui Shang1Zhen Luo2Zhen Luo3Yingbo Li4Yingbo Li5Guangxu Zhou6Guangxu Zhou7Yuchen Mao8Yuchen Mao9Hongyang Tan10Hongyang Tan11Kaiyi Mao12Kaiyi Mao13Peng Zhao14Peng Zhao15Cao Wang16Cao Wang17Zhu Jin18Zhu Jin19Yuanmei Liu20Yuanmei Liu21Department of Pediatric Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaDepartment of Pediatric Surgery, Guizhou Children’s Hospital, Zunyi, ChinaDepartment of Pediatric Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaDepartment of Pediatric Surgery, Guizhou Children’s Hospital, Zunyi, ChinaDepartment of Pediatric Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaDepartment of Pediatric Surgery, Guizhou Children’s Hospital, Zunyi, ChinaDepartment of Pediatric Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaDepartment of Pediatric Surgery, Guizhou Children’s Hospital, Zunyi, ChinaDepartment of Pediatric Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaDepartment of Pediatric Surgery, Guizhou Children’s Hospital, Zunyi, ChinaDepartment of Pediatric Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaDepartment of Pediatric Surgery, Guizhou Children’s Hospital, Zunyi, ChinaDepartment of Pediatric Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaDepartment of Pediatric Surgery, Guizhou Children’s Hospital, Zunyi, ChinaDepartment of Pediatric Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaDepartment of Pediatric Surgery, Guizhou Children’s Hospital, Zunyi, ChinaDepartment of Pediatric Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaDepartment of Pediatric Surgery, Guizhou Children’s Hospital, Zunyi, ChinaDepartment of Pediatric Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaDepartment of Pediatric Surgery, Guizhou Children’s Hospital, Zunyi, ChinaDepartment of Pediatric Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaDepartment of Pediatric Surgery, Guizhou Children’s Hospital, Zunyi, ChinaBackgroundCongenital primary obstructive megaureter (POM) is characterized by distal ureteral obstruction, leading to ureteral dilation, hydronephrosis, and potential renal impairment. Surgical intervention is necessary for severe hydronephrosis (SFU grade III–IV) or progressive renal decline. Open ureteral reimplantation is the standard treatment but is associated with significant surgical trauma and prolonged recovery. This study evaluates the safety and efficacy of transabdominal laparoscopic ureteral reimplantation (TALUR) at the posterior wall-bladder dome and compares its outcomes with the Politano procedure.MethodsThis retrospective, single-center study included pediatric POM patients who underwent ureteral reimplantation at the Affiliated Hospital of Zunyi Medical University from October 2019 to December 2023. Patients were assigned to the TALUR group (n = 21) or the Politano group (n = 20). Preoperative imaging, including renal ultrasound, magnetic resonance urography (MRU), and voiding cystourethrography (VCUG), confirmed the diagnosis. Primary endpoints included postoperative distal ureteral diameter, renal pelvic diameter, surgical success rate, perioperative complications, hospital stay, and vesicoureteral reflux (VUR) incidence. Follow-up assessments included ultrasound, MRU, and VCUG.ResultsAll procedures were successfully completed without conversion to open surgery. The TALUR group had a significantly shorter operative time (76.5 ± 12.6 min) compared to the Politano group (95.7 ± 14.8 min, P < 0.05). Postoperatively, distal ureteral diameter decreased from 14.6 ± 3.7 mm–4.8 ± 2.1 mm (P < 0.05), and renal pelvic dilation improved from 24.7 ± 5.3 mm–12.3 ± 2.6 mm (P < 0.05). The TALUR group had a shorter hospital stay (4.5 ± 0.5 vs. 6.1 ± 0.7 days, P < 0.05). Follow-up MRU showed improved ureteral patency and resolution of hydronephrosis. VCUG at six months showed mild VUR in two TALUR patients (9.5%) and one Politano patient (5.0%), all resolving within one year.ConclusionTALUR is a safe and effective minimally invasive technique for pediatric POM. Compared to the Politano procedure, TALUR offers shorter operative time, faster recovery, and comparable efficacy. Further large-scale studies are required to confirm its long-term effectiveness.https://www.frontiersin.org/articles/10.3389/fped.2025.1552433/fullcongenital primary obstructive megaureter (POM)transabdominal laparoscopic ureteral reimplantation (TALUR)politano procedureposterior wall-bladder domehydronephrosisvesicoureteral reflux (VUR) |
| spellingShingle | Xianhui Shang Xianhui Shang Zhen Luo Zhen Luo Yingbo Li Yingbo Li Guangxu Zhou Guangxu Zhou Yuchen Mao Yuchen Mao Hongyang Tan Hongyang Tan Kaiyi Mao Kaiyi Mao Peng Zhao Peng Zhao Cao Wang Cao Wang Zhu Jin Zhu Jin Yuanmei Liu Yuanmei Liu Transabdominal approach laparoscopic ureteral reimplantation at the top of the bladder for the treatment of primary obstructive megaureter Frontiers in Pediatrics congenital primary obstructive megaureter (POM) transabdominal laparoscopic ureteral reimplantation (TALUR) politano procedure posterior wall-bladder dome hydronephrosis vesicoureteral reflux (VUR) |
| title | Transabdominal approach laparoscopic ureteral reimplantation at the top of the bladder for the treatment of primary obstructive megaureter |
| title_full | Transabdominal approach laparoscopic ureteral reimplantation at the top of the bladder for the treatment of primary obstructive megaureter |
| title_fullStr | Transabdominal approach laparoscopic ureteral reimplantation at the top of the bladder for the treatment of primary obstructive megaureter |
| title_full_unstemmed | Transabdominal approach laparoscopic ureteral reimplantation at the top of the bladder for the treatment of primary obstructive megaureter |
| title_short | Transabdominal approach laparoscopic ureteral reimplantation at the top of the bladder for the treatment of primary obstructive megaureter |
| title_sort | transabdominal approach laparoscopic ureteral reimplantation at the top of the bladder for the treatment of primary obstructive megaureter |
| topic | congenital primary obstructive megaureter (POM) transabdominal laparoscopic ureteral reimplantation (TALUR) politano procedure posterior wall-bladder dome hydronephrosis vesicoureteral reflux (VUR) |
| url | https://www.frontiersin.org/articles/10.3389/fped.2025.1552433/full |
| work_keys_str_mv | AT xianhuishang transabdominalapproachlaparoscopicureteralreimplantationatthetopofthebladderforthetreatmentofprimaryobstructivemegaureter AT xianhuishang transabdominalapproachlaparoscopicureteralreimplantationatthetopofthebladderforthetreatmentofprimaryobstructivemegaureter AT zhenluo transabdominalapproachlaparoscopicureteralreimplantationatthetopofthebladderforthetreatmentofprimaryobstructivemegaureter AT zhenluo transabdominalapproachlaparoscopicureteralreimplantationatthetopofthebladderforthetreatmentofprimaryobstructivemegaureter AT yingboli transabdominalapproachlaparoscopicureteralreimplantationatthetopofthebladderforthetreatmentofprimaryobstructivemegaureter AT yingboli transabdominalapproachlaparoscopicureteralreimplantationatthetopofthebladderforthetreatmentofprimaryobstructivemegaureter AT guangxuzhou transabdominalapproachlaparoscopicureteralreimplantationatthetopofthebladderforthetreatmentofprimaryobstructivemegaureter AT guangxuzhou transabdominalapproachlaparoscopicureteralreimplantationatthetopofthebladderforthetreatmentofprimaryobstructivemegaureter AT yuchenmao transabdominalapproachlaparoscopicureteralreimplantationatthetopofthebladderforthetreatmentofprimaryobstructivemegaureter AT yuchenmao transabdominalapproachlaparoscopicureteralreimplantationatthetopofthebladderforthetreatmentofprimaryobstructivemegaureter AT hongyangtan transabdominalapproachlaparoscopicureteralreimplantationatthetopofthebladderforthetreatmentofprimaryobstructivemegaureter AT hongyangtan transabdominalapproachlaparoscopicureteralreimplantationatthetopofthebladderforthetreatmentofprimaryobstructivemegaureter AT kaiyimao transabdominalapproachlaparoscopicureteralreimplantationatthetopofthebladderforthetreatmentofprimaryobstructivemegaureter AT kaiyimao transabdominalapproachlaparoscopicureteralreimplantationatthetopofthebladderforthetreatmentofprimaryobstructivemegaureter AT pengzhao transabdominalapproachlaparoscopicureteralreimplantationatthetopofthebladderforthetreatmentofprimaryobstructivemegaureter AT pengzhao transabdominalapproachlaparoscopicureteralreimplantationatthetopofthebladderforthetreatmentofprimaryobstructivemegaureter AT caowang transabdominalapproachlaparoscopicureteralreimplantationatthetopofthebladderforthetreatmentofprimaryobstructivemegaureter AT caowang transabdominalapproachlaparoscopicureteralreimplantationatthetopofthebladderforthetreatmentofprimaryobstructivemegaureter AT zhujin transabdominalapproachlaparoscopicureteralreimplantationatthetopofthebladderforthetreatmentofprimaryobstructivemegaureter AT zhujin transabdominalapproachlaparoscopicureteralreimplantationatthetopofthebladderforthetreatmentofprimaryobstructivemegaureter AT yuanmeiliu transabdominalapproachlaparoscopicureteralreimplantationatthetopofthebladderforthetreatmentofprimaryobstructivemegaureter AT yuanmeiliu transabdominalapproachlaparoscopicureteralreimplantationatthetopofthebladderforthetreatmentofprimaryobstructivemegaureter |