Comparing open and pneumovesical approach for ureteric reimplantation in pediatric patients--a preliminary review.
OBJECTIVE
In this article, we are going to report our early experience on laparoscopic pneumovesical approach for ureteric reimplantation and to compare the result with traditional open approach.


METHODS
A retrospective review of patients who underwent ureteric reimplantation from 2000 to 2007 was carried out. They were divided into open and pneumovesical group according to the surgical approach. Comparison in terms of operative duration, hospital stay, and complication rate was made.


RESULTS
During the study period, a total of 22 ureteric reimplantation procedures were carried out. Thirteen and nine patients were operated by open and pneumovesical approaches, respectively. The mean age for operation in the 2 groups were similar (P = .62). Although the average operation time is 38.0 minutes longer in the pneumovesical group (P = .049), patients from this group had a hospital stay 2.3 days shorter than the open group (P = .065). Regarding curative success rate, both groups show similar result and were able to achieve more than 95% success rate. No major complications were found in the 2 groups. Cost-effective analysis favors pneumovesical approach in this study.


CONCLUSIONS
The pneumovesical approach is safe and effective for ureteric reimplantation in children. It offers less postoperative morbidities and shorter hospital stay when compared to traditional open method.
Chung
Patrick Ho Yu
PH
Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong.
Tang
Dorothy Yuen Yee
DY
Wong
Kenneth Kar Yuen
KK
Yip
Peter Kam Fai
PK
Tam
Paul Kwong Hang
PK
D002245:Carbon Dioxide / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007327:Insufflation; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D012086:Reoperation; D012092:Replantation / Q000379:methods*; D012189:Retrospective Studies; D015607:Stents; D014513:Ureter / Q000601:surgery*; D014517:Ureteral Obstruction / Q000601:surgery; D001743:Urinary Bladder / Q000601:surgery*; D014546:Urinary Catheterization; D014718:Vesico-Ureteral Reflux / Q000601:surgery
D002245:Carbon Dioxide