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Single-stage surgical approach in complicated paediatric ureteral duplication: surgical and functional outcome

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Abstract

Purpose

Surgical approach to children with complicated ureteral duplication is discussed controversially. Our aim was to determine the outcome of children with complicated renal duplication undergoing a single-stage surgical approach with laparoscopic partial nephrectomy and open bladder reconstruction.

Methods

Data of patients from 2004 to 2008 were investigated retrospectively. Outcome was analyzed in terms of postoperative course, renal function, urinary tract infection and functional voiding.

Results

Thirteen patients were treated with laparoscopic partial nephrectomy and reconstruction of the lower urinary tract in a single-stage approach. Median age at operation was 15 months (2–63 m). One girl had a renal triplication. 7/13 patients presented with an ectopic ureterocele, two with an ectopic ureter, severe vesicoureteral reflux occurred in 6 patients. All patients had non-functioning renal moieties. Mean operative time was 239 min (129–309; SD 50). One re-operation was necessary 4 years after primary surgery due to a pole remnant. All patients had uneventful recoveries without evidence of recurrent UTI. Postoperative 99mTc-MAG3 scans showed no significant reduction of partial renal function (p = 0.4), and no signs of obstruction (p = 0.188). During a median follow-up of 60 months (49–86), dysfunctional voiding occurred in one patient.

Conclusions

In children with complicated ureteral duplication a definitive single-stage procedure is feasible and shows excellent functional results.

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Conflict of interest

The authors state that there are no financial disclosures, conflicts of interest, and/or acknowledgments.

Ethical approval

The study was approved by the local IRB (IEC-Project No: 077/2013R).

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Authors and Affiliations

  1. Department of Pediatric Surgery and Pediatric Urology, University Children’s Hospital, Hoppe-Seyler-Str. 2, 72076, Tuebingen, Germany

    Verena Ellerkamp, Tobias Luithle & Joerg Fuchs

  2. Department of Pediatric Surgery, Lucerne Children’s Hospital, Lucerne, Switzerland

    Phillip Szavay

  3. Department of Diagnostic and Interventional Radiology, University Hospital, Tuebingen, Germany

    Juergen F. Schäfer

  4. Department of Pediatric Nephrology, University Children’s Hospital, Tuebingen, Germany

    Oliver Amon

Authors
  1. Verena Ellerkamp
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  2. Phillip Szavay
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  5. Oliver Amon
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  6. Joerg Fuchs
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Correspondence to Verena Ellerkamp.

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Ellerkamp, V., Szavay, P., Luithle, T. et al. Single-stage surgical approach in complicated paediatric ureteral duplication: surgical and functional outcome. Pediatr Surg Int 30, 99–105 (2014). https://doi.org/10.1007/s00383-013-3411-8

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