Extravesical Ureteral Reimplantations for the Correction of Primary Reflux Can Be Done as Outpatient Procedures

Marotte, Jeffrey B.; Smith, Dean

doi:10.1016/s0022-5347(05)66171-x

Cited by 48 publications

(14 citation statements)

References 21 publications

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“…Administrative databases lack patient-related data (such as baseline serum creatinine) that may also have had an independent impact on outcome. While several studies have suggested that the method used for reimplantation can affect outcome, details of the surgical methods used are not available in an administrative database and therefore could not be considered [4,[14][15][16][17]. Because a single code for ureteral reimplantation is used, we were also not able to distinguish certain variations of this procedure such as bilateral reimplantation or repeat reimplantation.…”

Section: Discussionmentioning

confidence: 97%

“…Ureteral reimplantation may be required to treat vesicoureteral reflux that is high-grade or does not resolve. This procedure is the most common pediatric urologic procedure requiring hospitalization and is usually associated with a brief LOS and few complications [2][3][4][5][6]. Various perioperative management techniques have been recommended to further reduce LOS and lower hospital costs of children undergoing ureteral reimplantation.…”

Section: Introductionmentioning

confidence: 99%

“…Various perioperative management techniques have been recommended to further reduce LOS and lower hospital costs of children undergoing ureteral reimplantation. These modifications include early removal of the urethral catheter, elimination of the use of drains, extravesicle ureteral reimplantation techniques, continuous epidural anesthesia, and the use of non-steroidal anti-inflammatory medications to reduce narcotic use [3,4,[6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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The effect of surgeon volume and hospital characteristics on in-hospital outcome after ureteral reimplantation in children

Dickstein

Barone

Liao³

et al. 2006

Ped Surgery Int

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The aim of this study was to examine the association between surgeon and hospital characteristics on in-hospital outcome after ureteral reimplantation in children. Patients<18 years undergoing vesicoureteral reimplantation (n=3,109) were identified in Kids' Inpatient Database, an administrative database containing discharge records from 27 states during 2000 in the US. Based on patient volume in 2000, surgeons were designated as low volume (<11 procedures), medium volume (11-20 procedures) and high volume (>20 procedures) surgeons. Length of stay and hospital charges were analyzed using multivariate linear regression analysis. A significant association between shorter length of stay and higher surgeon volume (p=0.02) was observed that was independent of children's hospital status, hospital volume and other hospital characteristics. Length of stay was 20% shorter when the procedure was performed by the highest volume surgeons compared to when performed by the lowest. No significant effect of surgeon volume on hospital charges, however, was observed. Higher surgeon volume was associated with shorter length of stay but no difference in hospital charges among children undergoing vesicoureteral reimplantation.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The effect of surgeon volume and hospital characteristics on in-hospital outcome after ureteral reimplantation in children

Dickstein

Barone

Liao³

et al. 2006

Ped Surgery Int

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“…This technique provides excellent success rates while providing a potentially less morbid surgical procedure compared to intravesical reimplantations. Without debilitating bladder spasms, fewer intravenous analgesic doses should be required and shorter length of stay should be theoretically possible [6][7][8][9][10] . We did not compare the operation time and healing period with the classic psoas hitch operation, nor did we observe any gross hematuria.…”

Section: Discussionmentioning

confidence: 99%

Modified Psoas Hitch with Lich-Gregoir Onlay Technique for the Reconstruction of Lower Ureter during Gynecologic or Obstetric Operations

Tahmaz¹,

Irkılata²,

Göktolga

et al. 2010

Urol Int

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Aims: We retrospectively review patients who underwent ureteral implantation with a psoas hitch during obstetric or gynecologic operations and describe a new modification. Methods: Between December 1997 and May 2005, 20 patients between 26 and 56 years underwent ureteral reimplantation by using the nonrefluxing, extravesical Lich-Gregoir onlay technique with psoas hitch at our institution by the same reconstructive surgery team. Additionally, we used a urethral catheter balloon as a landmark for the bladder mucosa and fixed the bladder to the psoas tendon by using the balloon. We performed 14 ureteral reimplantations during the surgery as intraoperative reconstruction. In 6 patients, delayed reconstruction of the ureter was performed a few days following the previous operation. Results: For intraoperative and delayed reconstructions, the mean operation time for ureteral reimplantation was 24 and 75 min. We took out the urethral catheter on the second operative day and the anastomotic drain on the third. The average hospital stay was 5.7 days. No cases of chronic flank pain, recurrent pyelonephritis, persistent severe hydronephrosis or compromised renal function occurred. No patient required reoperation. Conclusions: Modified psoas hitch ureteral reimplantation is an effective and safe way of reconstruction for treating defects in ureteral length.

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“…Die Behandlungsdauer im Krankenhaus für unterspritzte Patienten kann mit der einer offenen extravesikalen Antirefluxplastik verglichen werden, die in den USA z. T. ebenso als "Out-patient-Operation" angeboten wird [29,39,33]. Auch für die bilaterale extravesikale Antirefluxplastik konnte bewiesen werden, dass ein ambulantes Vorgehen ohne erhöhte Morbidität und insbesondere ohne erhöhtes Risiko für einen Harnverhalt möglich ist [30,35].…”

Section: Zusammenfassung Diskussionunclassified

Therapieoptionen beim primären vesikoureteralen Reflux

Ziesel

Frees

Thüroff

et al. 2012

Urologe

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Therapy of vesicoureteral reflux (VUR) has steadily changed during the last decade. Open surgical procedures, e.g. extravesical reflux repair with the Lich-Gregoir technique or ureterocystoneostomy with the psoas hitch technique, reference standards with excellent success rates, are less frequently used. Since its approval by the US Food and Drug Administration (FDA) endoscopic reflux therapy with Deflux® has gained more and more popularity. However, the usage of so-called bulking agents, e.g. Deflux®, still remains controversial in dilating reflux, while its application for low-grade VUR is increasingly being accepted. Despite higher recurrence rates in all grades of VUR, the use of the "minimally invasive injection" is increasing. The question has to be answered which therapy - if necessary - benefits the patient most. Which role has the subureteral injection gained and are open surgical procedures for VUR therapy "out"?

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Extravesical Ureteral Reimplantations for the Correction of Primary Reflux Can Be Done as Outpatient Procedures

Cited by 48 publications

References 21 publications

The effect of surgeon volume and hospital characteristics on in-hospital outcome after ureteral reimplantation in children

The effect of surgeon volume and hospital characteristics on in-hospital outcome after ureteral reimplantation in children

Modified Psoas Hitch with Lich-Gregoir Onlay Technique for the Reconstruction of Lower Ureter during Gynecologic or Obstetric Operations

Therapieoptionen beim primären vesikoureteralen Reflux

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