Functional ectopic ureter in case of ureteric duplication in children: initial experience with laparoscopic low transperitoneal ureteroureterostomy.
OBJECTIVE
In this paper, we discuss the value of the laparoscopic ipsilateral ureteroureterostomy for duplication anomalies of the urinary tract in children.


METHODS
A laparoscopic retroperitoneal ureteroureterostomy was undertaken in 2 children with 3-mm instruments and a 30-degree 5-mm optical trocar. Cystoscopy and stent placement in the recipient ureter was performed at the beginning of each procedure. The end-to-side anastomosis was performed with running 6:0 sutures. The type of procedure, position of operating devices, postoperative stenting, hospital stay, and outcome were recorded; each child had a control ultrasound at 6 months of follow-up.


RESULTS
The two operations were performed on girls. Patients were 8 and 18 months of age, respectively. Diagnosis was, in each case, obstructed upper pole ureter, without reflux and with a functioning upper pole. Operative time was 120 minutes. There were no intra- and no postoperative complications. Patients were discharged home after 4 and 7 days. Ultrasound at 6 months after the operations showed an important decrease of the ureterohydronephrosis in one case and a complete disappearance of any dilatation in the second case. Parenchyma of the upper poles were considered as normal.


CONCLUSIONS
Initial results of the minimally invasive ipsilateral ureteroureterostomy were excellent, with a minimal requirement of analgesia and perfect cosmetic results. Long-term follow-up, concentrating on the absence of urinary infection and of destruction of the upper poles, is mandatory.
Steyaert
Henri
H
Department of Pediatric Surgery, Lenval Foundation for Children, Nice, France. henri.steyaert@lenval.com
Lauron
Jerome
J
Merrot
Thierry
T
Leculee
Regine
R
Valla
Jean-Stephane
JS
D005260:Female; D006801:Humans; D007223:Infant; D010535:Laparoscopy; D014513:Ureter / Q000002:abnormalities* / Q000601:surgery*; D014519:Ureterostomy / Q000379:methods*; D013520:Urologic Surgical Procedures / Q000379:methods