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Laparoscopic ureteral reimplantation with extracorporeal tailoring and direct nipple ureteroneocystostomy for adult obstructive megaureter: long-term outcomes and comparison to open procedure

  • Urology - Original Paper
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Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusion

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.

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Acknowledgements

The authors are very grateful to the medical illustrator Madam Xinying Ma.

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Author notes

  1. Wenlong Zhong and Lin Yao have contributed equally to the study.

Authors and Affiliations

  1. 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

    Wenlong Zhong, Lin Yao, Kunlin Yang, Gang Wang, Xuesong Li & Liqun Zhou

  2. Department of Urology, Peking University People’s Hospital, No. 133 Fuchengmennei St, Xicheng District, Beijing, 100034, China

    Haoran Cui, Tao Xu & Xiongjun Ye

Authors
  1. Wenlong Zhong
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  2. Lin Yao
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  4. Kunlin Yang
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  5. Gang Wang
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Correspondence to Xiongjun Ye or Xuesong Li.

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The authors declare that they have no conflict of interest.

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 All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Informed consent was obtained from all individual participants included in the study.

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Zhong, W., Yao, L., Cui, H. et al. Laparoscopic ureteral reimplantation with extracorporeal tailoring and direct nipple ureteroneocystostomy for adult obstructive megaureter: long-term outcomes and comparison to open procedure. Int Urol Nephrol 49, 1973–1978 (2017). https://doi.org/10.1007/s11255-017-1687-7

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  • DOI: https://doi.org/10.1007/s11255-017-1687-7

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