Comparison of Open and Pneumovesical Cohen Approach for Treatment of Primary Vesicoureteral Junction Obstruction in Children

Wang, Jian; Mou, Yaru; Li, Aiwu

doi:10.1089/lap.2018.0791

Cited by 5 publications

(8 citation statements)

References 9 publications

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“…Blood loss was reported in five studies. 10,14,[17][18][19] Metaanalysis demonstrated a statistically significant decrease in…”

Section: Blood Lossmentioning

confidence: 97%

“…Blood loss was reported in five studies. 10,14,[17][18][19] Metaanalysis demonstrated a statistically significant decrease in blood loss for MIS compared with OUR while the statistical heterogeneity was evident (I 2 ¼ 100%, WMD -12.65, 95% CI -24.82 to -0.48; p ¼ 0.04; ►Fig. 3).…”

Section: Blood Lossmentioning

confidence: 98%

“…Twelve studies included operational time data, and nine of them were eligible for meta-analysis. [10][11][12][13][14][15][16][17][18] Meta-analysis show that no statistically significant difference was found between the MIS and OUR group with obvious statistical heterogeneity (I 2 ¼ 98%, WMD 20.73, 95% confidence interval [CI] -2.64 to 44.09; p ¼ 0.08; ►Fig. 2).…”

Section: Primary Outcome Measures Operative Timementioning

confidence: 99%

“…Postoperative UTI was observed in 12 studies. [10][11][12][13][14][16][17][18][19][21][22][23] There were 40 UTI cases (2.1%) in the OUR group and 47 cases (7.9%) in the MIS group. There was no statistically significant difference between the MIS and OUR groups (I 2 ¼ 0%, OR 1.16, 95% CI 0.71-1.89; p ¼ 0.55; ►Fig.…”

Section: Secondary Outcome Measures Postoperative Utimentioning

confidence: 99%

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Minimally Invasive versus Open Ureteral Reimplantation in Children: A Systematic Review and Meta-Analysis

Feng

Yang

et al. 2023

Eur J Pediatr Surg

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Purpose We performed a systematic review and meta-analysis to compare the safety and efficacy of minimally invasive surgery (MIS) versus open ureteral reimplantation (OUR) in children. Methods Literature searches were conducted to identify studies that compared MIS (laparoscopic ureteral reimplantation or robot-assisted laparoscopic ureteral replantation) and OUR in children. Parameters such as operative time, blood loss, length of hospital stay, success rate, postoperative urinary tract infection (UTI), urinary retention, postoperative hematuria, wound infection, and overall postoperative complications were pooled and compared by meta-analysis. Results Among the 7,882 pediatric participants in the 14 studies, 852 received MIS, and 7,030 received OUR. When compared with the OUR, the MIS approach resulted in shorter hospital stays (I 2 = 99%, weighted mean difference [WMD] –2.82, 95% confidence interval [CI] –4.22 to –1.41; p < 0.001), less blood loss (I 2 = 100%, WMD –12.65, 95% CI –24.82 to –0.48; p = 0.04), and less wound infection (I 2 = 0%, odds ratio 0.23, 95% CI 0.06–0.78; p = 0.02). However, no significant difference was found in operative time and secondary outcomes such as postoperative UTI, urinary retention, postoperative hematuria, and overall postoperative complications. Conclusion MIS is a safe, feasible, and effective surgical procedure in children when compared with OUR. Compared with OUR, MIS has a shorter hospital stay, less blood loss, and less wound infection. Furthermore, MIS is equivalent to OUR in terms of success rate and secondary outcomes such as postoperative UTI, urinary retention, postoperative hematuria, and overall postoperative complications. We conclude that MIS should be considered an acceptable option for pediatric ureteral reimplantation.

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“…Blood loss was reported in five studies. 10,14,[17][18][19] Metaanalysis demonstrated a statistically significant decrease in…”

Section: Blood Lossmentioning

confidence: 97%

Section: Blood Lossmentioning

confidence: 98%

Section: Primary Outcome Measures Operative Timementioning

confidence: 99%

Section: Secondary Outcome Measures Postoperative Utimentioning

confidence: 99%

See 2 more Smart Citations

Minimally Invasive versus Open Ureteral Reimplantation in Children: A Systematic Review and Meta-Analysis

Feng

Yang

et al. 2023

Eur J Pediatr Surg

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show abstract

“…Fu r t her more, i n t he f ield of ped iat r ic u rolog y, laparoscopic pneumovesical ureteral reimplantation for megau reters has been i ncreasi ngly il lust rated (34)(35)(36). Although with potential benefits compared with the open extravesical approach, including a reduction in postoperative bladder spasms, decreased incisional blood loss and pain, improved cosmetics, and prevention from VUR or anastomotic stricture, this procedure has not achieved widespread acceptance.…”

Section: Lurmentioning

confidence: 99%

Minimally invasive ureteral reimplantation or endoscopic management for primary obstructive megaureter: a narrative review of technical modifications and clinical outcomes

Yang

et al. 2022

Transl Androl Urol

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Background and Objective: Primary obstructive megaureter (POM) has various courses in different age populations. Although open ureteral reimplantation (OUR) remains the standard treatment for symptomatic POM, it is highly invasive with potential complications. In recent years, minimally invasive ureteral reimplantation (MIUR), including laparoscopic ureteral reimplantation (LUR) and roboticassisted laparoscopic ureteral reimplantation (RALUR), and endoscopic management, such as double-J stent insertion, endoureterotomy and endoscopic balloon dilatation (EBD), have been utilized for POM in selected patients. However, few comparable studies between MIUR and endoscopic management have been published to date, and it remains unclear which surgical management is the optimal choice for POM in different age groups. This review provides a comprehensive perspective on technical development and clinical outcomes of MIUR and endoscopic management for POM in pediatric and adult populations. Methods:The PubMed and Web of Science databases were used to comprehensively search English language articles related to MIUR and endoscopic management for POM in pediatric and adult populations up to March 2022. The technical modifications and the relevant clinical outcomes were reviewed. Key Content and Findings: MIUR with various technical modifications related to intracorporealsuturing and ureteroneocystostomy with anti-reflux techniques appears to be as safe and effective for POM in different age groups as the open procedure. Double-J stent insertion should be regarded as a temporary option for infants by achieving internal urinary drainage, as it may present limited success rates and various complications. Endoureterotomy using pure cutting current or laser appears to be a safer, easier, and less invasive alternative to open surgical management. While EBD has emerged as a definite treatment for POM in the pediatric population, it is debatable whether EBD can substitute for MIUR in adult patients. Conclusions:The safety and feasibility of MIUR and endoscopic management in patients from all age groups still need further investigation.

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Efficacy and safety of robot-assisted laparoscopic, laparoscopic and open surgery in ureteral reimplantation: a network meta-analysis and systematic review

Fan

Wang

et al. 2022

Updates Surg

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Comparison of Open and Pneumovesical Cohen Approach for Treatment of Primary Vesicoureteral Junction Obstruction in Children

Cited by 5 publications

References 9 publications

Minimally Invasive versus Open Ureteral Reimplantation in Children: A Systematic Review and Meta-Analysis

Minimally Invasive versus Open Ureteral Reimplantation in Children: A Systematic Review and Meta-Analysis

Minimally invasive ureteral reimplantation or endoscopic management for primary obstructive megaureter: a narrative review of technical modifications and clinical outcomes

Efficacy and safety of robot-assisted laparoscopic, laparoscopic and open surgery in ureteral reimplantation: a network meta-analysis and systematic review

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