To evaluate the long-term outcomes of laparoscopic ureteral reimplantation with extracorporeal tailoring and direct nipple ureteroneocystostomy for adult obstructive megaureter and compare the results with the open procedure.
From January 2007 to July 2013, 22 patients underwent laparoscopic and 28 patients underwent open ureteral reimplantation for adult obstructive megaureter. For laparoscopic group, the dilated ureter was delivered out of through a 12-mm port and the distal end was tailored and formed into an antireflux nipple extracorporeally. The ureteral nipple was intracorporeally reimplanted into the posterolateral wall of the bladder. Demographics, complications and follow-up data were analyzed and compared retrospectively between the groups.
Baseline characteristics including age, gender, body mass index, affected side, age at diagnosis and follow-up time were statistically similar for the groups. All of the surgeries were performed successfully, and no major complications occurred. Comparing with the open group, the use of our novel laparoscopic procedure resulted in less estimated blood loss (50.0 vs. 71.0 ml; P = 0.001), less narcotic analgesic (3.0 vs. 18.0 mg; P = 0.01) and shorter hospital stay (5.1 vs. 7.9 days; P < 0.001). Long-term outcomes including rates of recurrent ureteral stricture (4.5 vs. 0%; P = 0.25), rates of vesicoureteral reflux (9.1 vs. 3.6%, P = 0.42) and success rates (86.4 vs. 96.9%; P = 0.45) did not significantly differ between the two groups.
Laparoscopic ureteral reimplantation with extracorporeal tailoring and direct nipple ureteroneocystostomy is a safe and equally effective as the open surgery for the long-term outcomes of adult obstructive megaureter.
International urology and nephrology. 2017 Aug 29 [Epub ahead of print]
Wenlong Zhong, Lin Yao, Haoran Cui, Kunlin Yang, Gang Wang, Tao Xu, Xiongjun Ye, Xuesong Li, Liqun Zhou
Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, No. 8 Xishiku St, Xicheng District, Beijing, 100034, China., Department of Urology, Peking University People's Hospital, No. 133 Fuchengmennei St, Xicheng District, Beijing, 100034, China., Department of Urology, Peking University People's Hospital, No. 133 Fuchengmennei St, Xicheng District, Beijing, 100034, China. ., Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, No. 8 Xishiku St, Xicheng District, Beijing, 100034, China. .