Comparing open and pneumovesical approach for ureteric reimplantation in pediatric patients--a preliminary review

J Pediatr Surg. 2008 Dec;43(12):2246-9. doi: 10.1016/j.jpedsurg.2008.08.057.

Abstract

Background/purpose: In this article, we are going to report our early experience on laparoscopic pneumovesical approach for ureteric reimplantation and to compare the result with traditional open approach.

Methods: A retrospective review of patients who underwent ureteric reimplantation from 2000 to 2007 was carried out. They were divided into open and pneumovesical group according to the surgical approach. Comparison in terms of operative duration, hospital stay, and complication rate was made.

Results: During the study period, a total of 22 ureteric reimplantation procedures were carried out. Thirteen and nine patients were operated by open and pneumovesical approaches, respectively. The mean age for operation in the 2 groups were similar (P = .62). Although the average operation time is 38.0 minutes longer in the pneumovesical group (P = .049), patients from this group had a hospital stay 2.3 days shorter than the open group (P = .065). Regarding curative success rate, both groups show similar result and were able to achieve more than 95% success rate. No major complications were found in the 2 groups. Cost-effective analysis favors pneumovesical approach in this study.

Conclusions: The pneumovesical approach is safe and effective for ureteric reimplantation in children. It offers less postoperative morbidities and shorter hospital stay when compared to traditional open method.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Carbon Dioxide / administration & dosage
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Insufflation
  • Laparoscopy / methods*
  • Laparotomy / methods*
  • Length of Stay / statistics & numerical data
  • Male
  • Postoperative Complications / epidemiology
  • Reoperation
  • Replantation / methods*
  • Retrospective Studies
  • Stents
  • Ureter / surgery*
  • Ureteral Obstruction / surgery
  • Urinary Bladder / surgery*
  • Urinary Catheterization
  • Vesico-Ureteral Reflux / surgery

Substances

  • Carbon Dioxide