A comparative study on the efficacy of laparoscopic ureteroureterostomy versus single ureteral bladder reimplantation in treating pediatric complete renal duplication
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In brief
In brief
This retrospective study compares laparoscopic ureteroureterostomy to ureteral bladder reimplantation in 80 pediatric patients with complete renal duplication. Results show laparoscopic approach offers shorter operative time, less blood loss, and reduced hospital stay while achieving comparable functional outcomes and complication rates.
- Laparoscopic ureteroureterostomy offers shorter operative time and less blood loss than ureteral reimplantation for complete renal duplication.
- Both surgical approaches achieve comparable improvements in renal pelvis dilation, cortical thickness, and differential renal function postoperatively.
- Laparoscopic ureteroureterostomy reduces hospital stay and avoids bladder manipulation compared to traditional reimplantation.
- Complication rates are low and similar between techniques, with anastomotic stricture being the primary long-term concern.
- Both procedures are safe and effective for pediatric complete renal duplication; choice depends on surgical expertise and patient factors.
Written by the GCMD Library team from the article.
Abstract
Objective
To explore the therapeutic value of laparoscopic ureteroureterostomy compared to single ureteral bladder reimplantation in the treatment of pediatric complete renal duplication.
Methods
This retrospective study included 80 pediatric patients with complete renal duplication who underwent surgical treatment at the First Affiliated Hospital of Zhengzhou University from January 2015 to December 2022. Patients were divided into two groups based on the surgical approach: the laparoscopic ureteroureterostomy group (LUU group, n = 45) and the single ureteral bladder reimplantation group (UR group, n = 35). The two groups were compared in terms of operative time, intraoperative blood loss, number of stent placements, postoperative length of hospital stay, changes in ante-posterior diameter (APD) of the affected upper kidney pelvis before and after surgery, changes in upper ureteral diameter (UD), changes in upper renal cortex thickness (RCT) and variations in renal function.
Results
The LUU group demonstrated significantly shorter operative time (t = 3.480, P = 0.004), less intraoperative blood loss (t = −2.465, P = 0.0196), and reduced postoperative length of stay (t = 2.308, P = 0.027) compared to the UR group. There was no significant difference between the two groups regarding the number of stent placements (x2 = 0.762, P = 0.383). The UR group had four cases of long-term complications (two cases of anastomotic stricture, one case of vesicoureteral reflux, and one case of recurrent urinary tract infection), while the LUU group experienced one case of long-term complication (one case of anastomotic stricture), with no significant difference between groups (x2 = 1.493, P = 0.222). Both groups showed significant improvement in preoperative and postoperative APD, UD, RCT and affected side differential renal function (DRF). However, the differences in improvement values for upper kidney pelvis APD (ΔAPD; t = −0.032, P = 0.962), upper RCT (ΔRCT; t = −0.042, P = 0.957), ureteral diameter (ΔUD; t = 1.832, P = 0.079), and differential renal function (ΔDRF; Z = 1.895, P = 0.073) were not statistically significant.
Conclusion
Both LUU and UR procedures are safe and effective in treating pediatric complete renal duplication. Compared to UR, LUU results in shorter operative time, less intraoperative blood loss, and reduced postoperative length of stay, while also causing less damage to the bladder.