One Trocar-assisted Retroperitoneoscopic Ureteroureterostomy for Ureteral Duplication
NCT ID: NCT06350942
Last Updated: 2024-04-08
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
40 participants
OBSERVATIONAL
2016-09-30
2024-02-29
Brief Summary
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Detailed Description
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Demographic data of patients, their clinical manifestations, classification of hydronephrosis based on the guidelines established by the Society for Fetal Urology (SFU), dimensions of the renal pelvis measured in the anterior-posterior direction (APD), diameters of the ureters, duration of surgical procedures, duration of hospitalization, and subsequent follow-up information were systematically gathered prospectively to evaluate the long-term outcomes of the proposing surgical technique.
Conditions
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Study Design
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COHORT
RETROSPECTIVE
Study Groups
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Complete duplicated collecting system
The presence of two pelvicalyceal systems within a single kidney, with either obstructed or ectopic ureter
one trocar-assisted retroperitoneoscopic ureteroureterostomy (OTAU)
A 12 mm transverse incision was made just above the iliac crest, followed by careful dissection of the fascia and muscle layer to expose the Gerota's fascia. Entry into the retroperitoneal space was achieved with a 10-mm balloon trocar, allowing for pneumoretroperitoneum establishment. Using a 10-mm laparoscope equipped with a Maryland dissector, the ureters were dissected and isolated, followed by careful exteriorization of both upper and lower pole moiety ureters with a Babcock grasper. The pathological upper pole moiety ureter was transected, preserving the normal lower pole moiety ureter and shared blood supply, and closed with a Vicryl 4/0 suture. Subsequently, an end-to-side ureteroureterostomy was performed with a 6/0 Polydioxanone running suture, with antegrade insertion of a double J stent if not previously conducted. A final retroperitoneoscopic evaluation ensured proper anastomosis alignment, and the incision was closed without drainage.
Interventions
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one trocar-assisted retroperitoneoscopic ureteroureterostomy (OTAU)
A 12 mm transverse incision was made just above the iliac crest, followed by careful dissection of the fascia and muscle layer to expose the Gerota's fascia. Entry into the retroperitoneal space was achieved with a 10-mm balloon trocar, allowing for pneumoretroperitoneum establishment. Using a 10-mm laparoscope equipped with a Maryland dissector, the ureters were dissected and isolated, followed by careful exteriorization of both upper and lower pole moiety ureters with a Babcock grasper. The pathological upper pole moiety ureter was transected, preserving the normal lower pole moiety ureter and shared blood supply, and closed with a Vicryl 4/0 suture. Subsequently, an end-to-side ureteroureterostomy was performed with a 6/0 Polydioxanone running suture, with antegrade insertion of a double J stent if not previously conducted. A final retroperitoneoscopic evaluation ensured proper anastomosis alignment, and the incision was closed without drainage.
Eligibility Criteria
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Inclusion Criteria
* Age no more than 18 years old
* The surgical technique performed must be one trocar-assisted retroperitoneoscopic ureteroureterostomy.
* Followed up at least 2-4 years
Exclusion Criteria
* Patients with prior urologic surgeries or other urological anomalies
1 Month
10 Years
ALL
No
Sponsors
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Vinmec Research Institute of Stem Cell and Gene Technology
OTHER
National Children's Hospital, Vietnam
OTHER
Responsible Party
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Nguyen Thanh Quang
Pediatric Surgeon
Principal Investigators
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Quang T Nguyen, M.D.
Role: PRINCIPAL_INVESTIGATOR
: Department of Pediatric Surgery, The National Hospital of Pediatrics, Hanoi, Vietnam
Locations
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The National Hospital of Pediatrics
Hanoi, , Vietnam
Vinmec Research Institute of Stem Cell and Gene Technology
Hanoi, , Vietnam
Countries
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References
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Glassberg KI, Braren V, Duckett JW, Jacobs EC, King LR, Lebowitz RL, Perlmutter AD, Stephens FD. Suggested terminology for duplex systems, ectopic ureters and ureteroceles. J Urol. 1984 Dec;132(6):1153-4. doi: 10.1016/s0022-5347(17)50072-5.
Chacko JK, Koyle MA, Mingin GC, Furness PD 3rd. Ipsilateral ureteroureterostomy in the surgical management of the severely dilated ureter in ureteral duplication. J Urol. 2007 Oct;178(4 Pt 2):1689-92. doi: 10.1016/j.juro.2007.05.098. Epub 2007 Aug 17.
Fernbach SK, Feinstein KA, Spencer K, Lindstrom CA. Ureteral duplication and its complications. Radiographics. 1997 Jan-Feb;17(1):109-27. doi: 10.1148/radiographics.17.1.9017803.
Stokland E, Jodal U, Sixt R, Swerkersson S, Hansson S. Uncomplicated duplex kidney and DMSA scintigraphy in children with urinary tract infection. Pediatr Radiol. 2007 Aug;37(8):826-8. doi: 10.1007/s00247-007-0518-x. Epub 2007 Jun 26.
Timberlake MD, Corbett ST. Minimally invasive techniques for management of the ureterocele and ectopic ureter: upper tract versus lower tract approach. Urol Clin North Am. 2015 Feb;42(1):61-76. doi: 10.1016/j.ucl.2014.09.006. Epub 2014 Oct 11.
McLeod DJ, Alpert SA, Ural Z, Jayanthi VR. Ureteroureterostomy irrespective of ureteral size or upper pole function: a single center experience. J Pediatr Urol. 2014 Aug;10(4):616-9. doi: 10.1016/j.jpurol.2014.05.003. Epub 2014 Jun 2.
Lashley DB, McAleer IM, Kaplan GW. Ipsilateral ureteroureterostomy for the treatment of vesicoureteral reflux or obstruction associated with complete ureteral duplication. J Urol. 2001 Feb;165(2):552-4. doi: 10.1097/00005392-200102000-00067.
Prieto J, Ziada A, Baker L, Snodgrass W. Ureteroureterostomy via inguinal incision for ectopic ureters and ureteroceles without ipsilateral lower pole reflux. J Urol. 2009 Apr;181(4):1844-8; discussion 1848-50. doi: 10.1016/j.juro.2008.12.004. Epub 2009 Feb 23.
Cundy TP, Shetty K, Clark J, Chang TP, Sriskandarajah K, Gattas NE, Najmaldin A, Yang GZ, Darzi A. The first decade of robotic surgery in children. J Pediatr Surg. 2013 Apr;48(4):858-65. doi: 10.1016/j.jpedsurg.2013.01.031.
Herz D, Smith J, McLeod D, Schober M, Preece J, Merguerian P. Robot-assisted laparoscopic management of duplex renal anomaly: Comparison of surgical outcomes to traditional pure laparoscopic and open surgery. J Pediatr Urol. 2016 Feb;12(1):44.e1-7. doi: 10.1016/j.jpurol.2015.04.046. Epub 2015 Aug 17.
Wong NC, Braga LH. Open ureteroureterostomy for repair of upper-pole ectopic ureters in children with duplex systems: is stenting really necessary? J Pediatr Urol. 2019 Feb;15(1):72.e1-72.e7. doi: 10.1016/j.jpurol.2018.10.014. Epub 2018 Oct 24.
Gonzalez R, Piaggio L. Initial experience with laparoscopic ipsilateral ureteroureterostomy in infants and children for duplication anomalies of the urinary tract. J Urol. 2007 Jun;177(6):2315-8. doi: 10.1016/j.juro.2007.01.177.
Lowe GJ, Canon SJ, Jayanthi VR. Laparoscopic reconstructive options for obstruction in children with duplex renal anomalies. BJU Int. 2008 Jan;101(2):227-30. doi: 10.1111/j.1464-410X.2007.07106.x. Epub 2007 Sep 13.
Chandrasekharam V, Jayaram H. Laparoscopic ipsilateral ureteroureterostomy for the management of children with duplication anomalies. J Indian Assoc Pediatr Surg. 2015 Jan;20(1):27-31. doi: 10.4103/0971-9261.145442.
Storm DW, Modi A, Jayanthi VR. Laparoscopic ipsilateral ureteroureterostomy in the management of ureteral ectopia in infants and children. J Pediatr Urol. 2011 Oct;7(5):529-33. doi: 10.1016/j.jpurol.2010.08.004. Epub 2010 Sep 25.
Lee NG, Corbett ST, Cobb K, Bailey GC, Burns AS, Peters CA. Bi-Institutional Comparison of Robot-Assisted Laparoscopic Versus Open Ureteroureterostomy in the Pediatric Population. J Endourol. 2015 Nov;29(11):1237-41. doi: 10.1089/end.2015.0223. Epub 2015 Aug 21.
Kawal T, Srinivasan AK, Talwar R, Chu DI, Long C, Weiss D, Van Batavia J, Kolon TF, Shukla AR. Ipsilateral ureteroureterostomy: does function of the obstructed moiety matter? J Pediatr Urol. 2019 Feb;15(1):50.e1-50.e6. doi: 10.1016/j.jpurol.2018.08.012. Epub 2018 Aug 20.
Biles MJ, Finkelstein JB, Silva MV, Lambert SM, Casale P. Innovation in Robotics and Pediatric Urology: Robotic Ureteroureterostomy for Duplex Systems with Ureteral Ectopia. J Endourol. 2016 Oct;30(10):1041-1048. doi: 10.1089/end.2015.0645. Epub 2016 Sep 16.
Liem NT, Dung LA, Viet ND. Single trocar retroperitoneoscopic assisted ipsilateral ureteroureterostomy for ureteral duplication. Pediatr Surg Int. 2012 Oct;28(10):1031-4. doi: 10.1007/s00383-012-3158-7. Epub 2012 Aug 12.
Grimsby GM, Merchant Z, Jacobs MA, Gargollo PC. Laparoscopic-assisted ureteroureterostomy for duplication anomalies in children. J Endourol. 2014 Oct;28(10):1173-7. doi: 10.1089/end.2014.0113. Epub 2014 Aug 13.
Bieri M, Smith CK, Smith AY, Borden TA. Ipsilateral ureteroureterostomy for single ureteral reflux or obstruction in a duplicate system. J Urol. 1998 Mar;159(3):1016-8.
Other Identifiers
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1451_01/BVNTW-VNCSKTE
Identifier Type: -
Identifier Source: org_study_id
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