MODIFIED Politano-Leadbetter REIMPLANTATION FOR TREATMENT OF CONGENITAL MALFORMATION OF VESICOURETERAL JUNCTION IN CHILDREN_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZENGLi , HUANGYidong , KANGLei , HUANGGuizhen , YUANMiao , ZHANGYue , ZHANGJie ,  HUANGLugang

Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P. R. China;

Corresponding?author：

HUANGLugang, Email: lugang992001@aliyun.com

Keywords：

Modified Politano-Leadbetter reimplantation; Ureteric reimplantation; Vesicoureteral junction obstruction; Vesicoureteral reflux; Children

DOI：

10.7507/1002-1892.20150277

Video：

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Objective To explore the effectiveness of modified Politano-Leadbetter reimplantation for the treatment of congenital malformation of the vesicoureteral junction in children. Methods A retrospective analysis was made on the clinical data of 53 patients with congenital malformation of the vesicoureteral junction treated with modified Politano-Leadbetter reimplantation between June 2000 and October 2014. Of 53 cases, there were 24 boys and 29 girls, aged from 8 months to 7 years (mean, 2.1 years); 23 had congenital vesicoureteral junction obstruction (14 left, 5 right, and 4 bilateral), and 30 had vesicoureteral reflux (12 unilateral, 18 bilateral), which were verified by voiding cystourethrography. The disease duration was from 1 month to 1 year (mean, 5 months). Results All of the patients underwent modified Politano-Leadbetter reimplantation successfully. The mean operation time was 74 minutes (range, 65-85 minutes) for unilateral cases and 105 minutes (range, 98-130 minutes) for bilateral cases. There was no dysuria, infection of incision, or incision dehiscence after urinary catheter removal. The follow-up time was 6 months to 14 years (median, 28 months); all patients were free from complications of fistula, vesicoureteral reflux, vesicoureteral junction obstruction, or hypertension. The new ureteral orifices had good appearance at 1 month after operation. Urologic ultrasound showed that hydronephrosis relieved at 3 months after operation. Urinary tract infection rate was 13.2% (7/53) during 6 months after operation, which was cured by antibiotics. Voiding cystourethrography showed no vesicoureteral reflux in 32 cases at 6 months after operation. Conclusion The modified Politano-Leadbetter reimplantation simplifies the operation course, which has the longitudinal ureter after operation and is similar to physiological state. It is a safe and effective option for congenital malformation of vesicoureteral junction in children with few complications, especially for patients with unilateral megaloureter.

Citation： ZENGLi, HUANGYidong, KANGLei, HUANGGuizhen, YUANMiao, ZHANGYue, ZHANGJie, HUANGLugang. MODIFIED Politano-Leadbetter REIMPLANTATION FOR TREATMENT OF CONGENITAL MALFORMATION OF VESICOURETERAL JUNCTION IN CHILDREN. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(10): 1279-1283. doi: 10.7507/1002-1892.20150277 Copy

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6.	Lee OT, Durbin-Johnson B, Kurzrock EA. Physician preference is a major factor in management of vesicoureteral reflux. Pediatr Nephrol, 2015, 30(1):131-138.
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11.	Schober MS, Jayanthi VR. Vesicoscopic ureteral reimplant:is there a role in the age of robotics? Urol Clin North Am, 2015, 42(1):53-59.
12.	Song SH, Kim KS. Current status of robot-assisted laparoscopic surgery in pediatric urology. Korean J Urol, 2014, 55(8):499-504.
13.	Stephen YN, Thomas HS. Campbell's urology. 10th eds. Philadelphia:W.B. Saunders Co., 2012:1122-1168.
14.	習林云, 何大維, 劉星, 等. 腹腔鏡下Cohen及改良Glenn-Anderson 輸尿管膀胱再植術的療效比較. 中國微創外科雜志, 2015, 15(1): 36-39.
15.	Soh S, Kobori Y, Shin T, et al. Transvesicoscopic ureteral reimplantation:Politano-Leadbetter versus Cohen technique. Int J Urol, 2015, 22(4):394-399.
16.	何大維, 林濤, 魏光輝, 等. 經膀胱內腹腔鏡手術治療膀胱輸尿管連接處疾病. 中華小兒外科雜志, 2009, 30(9):585-587.
17.	Grimsby GM, Dwyer ME, Jacobs MA, et al. Multi-institutional review of outcomes of robot-assisted laparoscopic extravesical ureteral reimplantation. J Urol, 2015, 193(5 Suppl): 1791-1795.
18.	Ashcraft KW, Murphy JP, Sharp RJ, et al. Pediatric surgery. 3rd eds. Philadelphia:W.B. Saunders Co., 2000:706-722.
19.	Nelson CP, Hubert KC, Kokorowski PJ, et al. Long-term incidence of urinary tract infection after ureteral reimplantation for primary vesicoureteral reflux. J Pediatr Urol, 2013, 9(1):92-98.
20.	Heidenreich A, Ozgur E, Becker T, et al. Surgical management of vesicoureteral reflux in pediatric patients. World J Urol, 2004, 22(2): 96-106.
21.	Kocherov S, Ulman I, Nikolaev S, et al. Multicenter survey of endoscopic treatment of vesicoureteral reflux using polyacrylate-polyalcohol bulking copolymer (Vantris). Urology, 2014, 84(3):689-693.

1. 黃澄. 實用小兒泌尿外科學. 北京:人民衛生出版社, 2006:301-305.
2. Gill IS, Ponsky LE, Desai M, et al. Laparoscopic cross-trigonal cohen ureteroneocystostomy:novel technique. J Urol, 2001, 166(5):1811-1814.
3. Hendren WH, Perovic S. Hinman's Atlas of Pediatric Urologic Surgery. 2nd eds. Philadelphia:W.B. Sauders Co., 2009:256-264.
4. Zderic SA. Hinman's Atlas of Pediatric Urologic Surgery. 2nd eds. Philadelphia:W.B. Sauders Co., 2009:265-266.
5. Tullus K. Vesicoureteric reflux in children. Lancet, 2015, 385(9965): 371-379.
6. Lee OT, Durbin-Johnson B, Kurzrock EA. Physician preference is a major factor in management of vesicoureteral reflux. Pediatr Nephrol, 2015, 30(1):131-138.
7. 孫玉芳, 畢允力, 阮雙歲, 等. 氣膀胱腹腔鏡在膀胱輸尿管連接處狹窄性畸形中的臨床應用. 中華小兒外科雜志, 2012, 33(7):504-507.
8. Marte A, Sabatino MD, Borrelli M, et al. Pneumovesicoscopic correction of primary vesicoureteral reflux (VUR) in children. Our experience. Eur J Pediatr Surg, 2010, 20(6):366-370.
9. Chung MS, Han SW, Jung HJ, et al. Transvesicoscopic ureteral reimplantation in children with bilateral vesicoureteral reflux: surgical technique and results. J Laparoendosc Adv Surg Tech A, 2012, 22(3):295-300.
10. Weiss DA, Shukla AR. The robotic-assisted ureteral reimplantation: the evolution to a new standard. Urol Clin North Am, 2015, 42(1): 99-109.
11. Schober MS, Jayanthi VR. Vesicoscopic ureteral reimplant:is there a role in the age of robotics? Urol Clin North Am, 2015, 42(1):53-59.
12. Song SH, Kim KS. Current status of robot-assisted laparoscopic surgery in pediatric urology. Korean J Urol, 2014, 55(8):499-504.
13. Stephen YN, Thomas HS. Campbell's urology. 10th eds. Philadelphia:W.B. Saunders Co., 2012:1122-1168.
14. 習林云, 何大維, 劉星, 等. 腹腔鏡下Cohen及改良Glenn-Anderson 輸尿管膀胱再植術的療效比較. 中國微創外科雜志, 2015, 15(1): 36-39.
15. Soh S, Kobori Y, Shin T, et al. Transvesicoscopic ureteral reimplantation:Politano-Leadbetter versus Cohen technique. Int J Urol, 2015, 22(4):394-399.
16. 何大維, 林濤, 魏光輝, 等. 經膀胱內腹腔鏡手術治療膀胱輸尿管連接處疾病. 中華小兒外科雜志, 2009, 30(9):585-587.
17. Grimsby GM, Dwyer ME, Jacobs MA, et al. Multi-institutional review of outcomes of robot-assisted laparoscopic extravesical ureteral reimplantation. J Urol, 2015, 193(5 Suppl): 1791-1795.
18. Ashcraft KW, Murphy JP, Sharp RJ, et al. Pediatric surgery. 3rd eds. Philadelphia:W.B. Saunders Co., 2000:706-722.
19. Nelson CP, Hubert KC, Kokorowski PJ, et al. Long-term incidence of urinary tract infection after ureteral reimplantation for primary vesicoureteral reflux. J Pediatr Urol, 2013, 9(1):92-98.
20. Heidenreich A, Ozgur E, Becker T, et al. Surgical management of vesicoureteral reflux in pediatric patients. World J Urol, 2004, 22(2): 96-106.
21. Kocherov S, Ulman I, Nikolaev S, et al. Multicenter survey of endoscopic treatment of vesicoureteral reflux using polyacrylate-polyalcohol bulking copolymer (Vantris). Urology, 2014, 84(3):689-693.

Chinese Journal of Reparative and Reconstructive Surgery

MODIFIED Politano-Leadbetter REIMPLANTATION FOR TREATMENT OF CONGENITAL MALFORMATION OF VESICOURETERAL JUNCTION IN CHILDREN

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