title: Transvesical laparoscopic cross-trigonal ureteral reimplantation for correction of vesicoureteral reflux: initial experience and comparisons between adult and pediatric cases.
abstract: OBJECTIVE
  Transvesical laparoscopic cross-trigonal ureteral reimplantation (TLCUR) has been reported as an alternative procedure for vesicoureteral reflux mainly in pediatric cases. We review our initial experience with TLCUR and evaluate its feasibility in adult patients.
  
  
  METHODS
  We performed TLCUR in 30 patients (22 females and 24 bilateral cases) with a median age of 14.5 years.
  
  
  RESULTS
  The median operating time was 145 minutes in the unilateral cases and 230 minutes in the bilateral cases. Blood loss was minimal in all cases. No intraoperative complications were observed. The urethral catheter was removed at day 2 to 3. One persistence of reflux and one uretero-vesico anastomosis stricture were observed. The total success rate of 49 ureters in 27 patients, in whom postoperative cystography was performed, was 96% (47/49). Comparing the first 15 and last 15 cases, patient age was similar, the operation time was significantly shorter in the last 15 cases, and both operative failures were found in the first 15 cases. Comparing the 15 pediatric and 15 adult cases, the operation time did not differ between the two groups and one operative failure was observed in each group.
  
  
  CONCLUSIONS
  This procedure was an effective and safe alternative minimally invasive procedure for both adult and pediatric patients with reflux.
authors.affiliation: Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan. kawauchi@koto.kpu-m.ac.jp
authors.forename: Akihiro
authors.initials: A
authors.lastname: Kawauchi
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Naitoh
authors.forename: Jintetsu
authors.initials: J
authors.lastname: Soh
authors.forename: Naoki
authors.initials: N
authors.lastname: Hirahara
authors.forename: Koji
authors.initials: K
authors.lastname: Okihara
authors.forename: Tsuneharu
authors.initials: T
authors.lastname: Miki
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000473:pathology; D005260:Female; D006801:Humans; D007223:Infant; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation; D013536:Suture Techniques; D014513:Ureter / Q000601:surgery*; D001743:Urinary Bladder / Q000601:surgery*; D014718:Vesico-Ureteral Reflux / Q000601:surgery*