One Trocar-assisted Retroperitoneoscopic Ureteroureterostomy for Ureteral Duplication

National Children's Hospital, Vietnam

Status: Completed

Conditions: Ureteral Duplication

Treatments: Procedure: one trocar-assisted retroperitoneoscopic ureteroureterostomy (OTAU)

Study type: Observational

Funder types: Other

Identifiers

NCT06350942

1451_01/BVNTW-VNCSKTE

Details and patient eligibility

About

Ureteral duplication, a common anomaly affecting about 0.8% of the population, presents challenges in pediatric urology due to its diverse clinical presentations and anatomical complexity. Traditional treatments like upper pole moiety (UPM) heminephrectomy can lead to loss of renal function in the remaining lower pole moiety (LPM). Ureteroureterostomy (UU) is a safer alternative, increasingly preferred regardless of renal function or reflux presence. Minimally invasive techniques like laparoscopic and robotic procedures show promise, but robotic-assisted UU is costly, while laparoscopic UU has technical challenges. A novel approach is proposed: single-trocar retroperitoneoscopic-assisted UU, combining laparoscopic visualization advantages with simplified extracorporeal suturing, offering a promising solution for managing complete ureteral duplication. The present study was designed to describe the operative technique and outcome of OTAU in 40 cases of complete ureteral duplication in children.

Full description

Ureteral duplication, a common anomaly affecting about 0.8% of the population, presents challenges in pediatric urology due to its diverse clinical presentations and anatomical complexity. Traditional treatments like upper pole moiety (UPM) heminephrectomy can lead to loss of renal function in the remaining lower pole moiety (LPM). Ureteroureterostomy (UU) is a safer alternative, increasingly preferred regardless of renal function or reflux presence. Minimally invasive techniques like laparoscopic and robotic procedures show promise, but robotic-assisted UU is costly, while laparoscopic UU has technical challenges. A novel approach is proposed: single-trocar retroperitoneoscopic-assisted UU, combining laparoscopic visualization advantages with simplified extracorporeal suturing, offering a promising solution for managing complete ureteral duplication. The present study was designed to describe the operative technique and outcome of OTAU in 40 cases of complete ureteral duplication in children.

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.

Enrollment: 40 patients

Sex: All

Ages: 1 month to 10 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Clinical diagnosis of ureteral duplication.
• 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 exhibiting reflux to the ureter of the lower pole moiety (LPM)
• Patients with prior urologic surgeries or other urological anomalies

Trial design

40 participants in 1 patient group

Complete duplicated collecting system

Description:

The presence of two pelvicalyceal systems within a single kidney, with either obstructed or ectopic ureter

Treatment:

Procedure: one trocar-assisted retroperitoneoscopic ureteroureterostomy (OTAU)