Laparoscopic Upper-pole Heminephrectomy for the Management of Duplex Kidney: Outcomes of a Multicenter Cohort

Szklarz, María Tatiana; Ruiz, Javier; Moldes, Juan; Sentagne, Arturo; Tuchbaum, Virginia; Tessi, Catalina; Imizcoz, Felicitas Lopez; Weller, Santiago; Vagni, Roberto; Ormaechea, María; Burek, Carol; Sager, Cristian; Badiola, Francisco de; Corbetta, Juan Pablo

doi:10.1016/j.urology.2021.01.032

Cited by 7 publications

(3 citation statements)

References 19 publications

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“…Duplicated kidney is a congenital anomaly of the urinary system, commonly occurring in female children ( 8 ). The occurrence probability is approximately equal between the left and right sides, with bilateral cases being less common ( 9 ). The characteristic feature of duplicated kidneys is that one kidney is divided into upper and lower independent excretory systems on one side, usually separated by a shallow groove, each with its own renal pelvis, ureter, and blood vessels ( 10 ).…”

Section: Discussionmentioning

confidence: 99%

Comparative analysis of laparoscopic and open ureteroureterostomy for the treatment of pediatric duplicated kidneys: a clinical efficacy and safety study

Tao,

Mao,

Cao

2024

Transl Pediatr

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Background Duplicated kidneys, though rare, are common in pediatric urinary issues. For children with complete kidney duplication and symptoms or complications, surgery is often needed. Ureteroureterostomy (UU) is a common procedure for this condition. This study aims to evaluate and compare the clinical efficacy and safety of laparoscopic ureteroureterostomy (LUU) and open ureteroureterostomy (OUU) in the treatment of pediatric duplicated kidneys. Methods A retrospective study at Children’s Hospital of Anhui Province from February 2017 to January 2023 included pediatric patients who underwent LUU or OUU for completely duplicated kidneys. Comparative measures included operative time, postoperative hospital stay, intraoperative blood loss, pre- and postoperative renal pelvis anteroposterior diameter, pre- and postoperative upper renal parenchymal thickness, pre- and postoperative upper ureteral diameter, and postoperative complications. Results There are 30 patients, 20 in the LUU group and 10 in the OUU group. All patients underwent surgery successfully, with no conversions to open surgery in the LUU group. Comparison between the LUU group (average age 3.7±3.4 years) and the OUU group (average age 1.6±1.3 years) showed that laparoscopic surgery had a mean duration of 178.8±60.71 min, intraoperative blood loss of 4.3±0.92 mL, drainage tube removal time of 1.8±0.6 days, and postoperative hospital stay of 4.2±2.2 days. In contrast, the OUU group had a mean surgery duration of 181.6±37.8 min, drainage tube removal time of 2.3±0.7 days, intraoperative blood loss of 6.4±4.06 mL, and postoperative hospital stay of 5.8±1.8 days. Although the LUU group had a shorter surgical duration, the difference was not statistically significant. However, intraoperative blood loss, drainage tube removal time, and postoperative hospital stay were significantly reduced in the LUU group, with statistical significance (P<0.05). After surgery, one case of urinary tract infection occurred in each group. Both groups had double-J stents placed postoperatively, which were removed cystoscopically 4–6 weeks later. Preoperative examinations showed no significant differences between the LUU and OUU groups in terms of upper renal pelvis anteroposterior diameter, upper renal ureteral diameter, and upper renal parenchymal thickness. However, in terms of postoperative recovery indicators, the LUU group outperformed the OUU group significantly, including upper renal pelvis anteroposterior diameter, upper renal ureteral diameter, and upper renal parenchymal thickness, with statistical significance (P<0.05). No hydronephrosis or worsening hydronephrosis was observed in the lower kidneys and ureters of the 30 patients postoperatively. Symptoms disappeared in patients with preoperative dribbling, and pain symptoms in the waist and abdomen relieved. No postoperative febrile urinary tract infections were observed. Conclusions UU is an effective and safe m...

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Section: Discussionmentioning

confidence: 99%

Comparative analysis of laparoscopic and open ureteroureterostomy for the treatment of pediatric duplicated kidneys: a clinical efficacy and safety study

Tao,

Mao,

Cao

2024

Transl Pediatr

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“…However, it is controversial whether the operation should be performed in patients with renal function <10% and no relevant clinical symptom. Proponents believe that surgical removal of non-functional or dysplasia renal tissue and ureters can prevent the long-term occurrence of hypertension or pyelonephritis ( 1 , 19 ). On the contrary, the possibility of long-term hypertension and pyelonephritis in the non-functional kidney is low, and the operation will easily affect the blood supply and function of the lower kidney, leading to kidney loss ( 15 , 20 , 21 ).…”

Section: Discussionmentioning

confidence: 99%

Treatment for complete bilateral duplex kidneys with severe hydronephrosis and ureterectasis of the upper moiety in a child: A case report and literature review

Ji²,

Zhang³

et al. 2022

Front. Surg.

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AimTo explore the treatment experience of the duplex kidney.MethodA case of the complete bilateral duplex kidney with severe hydronephrosis and ureterectasis in the upper moiety of the kidney diagnosed in the Department of Urology of Kunming Children's Hospital from 2021 to 2022 was retrospectively analyzed and relevant literature was reviewed.ResultsA 2-month-old baby girl was admitted to the hospital because of hydronephrosis of bilateral kidneys found by prenatal ultrasound for 3 months and fever for 3 days. After being given the relevant examinations, the girl was diagnosed with complete bilateral duplex kidneys with severe hydronephrosis and ureterectasis in the upper moiety, and urinary tract infection. The patient's urinary tract infection was poorly controlled after positive anti-infective therapy, so a bilateral ureterostomy was performed. After the surgery, urinary tract infection was soon cured. A bilateral ureteroureterostomy was performed 13 months later, and the patient recovered after 7 days.ConclusionCutaneous ureterostomy combined with late ureteroureterostomy for children with complete bilateral duplex kidneys with severe hydronephrosis in the upper moiety and ureter are not only beneficial to caregivers’ nursing after the operation, but also have significance for salvaging renal function.

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“…Currently, this procedure is frequently performed using a laparoscopic approach. While the open approach is also relatively common, a gradual shift towards the robotic technique is imminent [39]. In adults, hemi-NU is much less common.…”

Section: Hemi-nephroureterectomy Considerationsmentioning

confidence: 99%

Management of Upper Tract Urothelial Carcinoma in a Double Collecting System Kidney

Zohar,

Sivan,

Mintz

et al. 2024

JPM

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Upper tract urothelial carcinoma (UTUC) in a duplex collecting system (DCS) is a relatively uncommon presentation with unclear management guidelines. Herein, we retrospectively reviewed all published cases of DCS with UTUC aiming to suggest personalized clinical care options for future cases. We conducted a systematic search for all cases of UTUC in DCS from published literature using the following keywords: UTUC, urothelial carcinoma (UC), collecting duct carcinoma, and DCS. The cases were summarized based on demographics, clinical presentation, predisposing risk factors, tumor location, management, and follow-up. We present an additional case based on our experience with a 69-year-old female with high-grade (HG) UTUC of the upper moiety in complete DCS. The patient underwent a robotic upper pole hemi-nephroureterectomy (hemi-NU) with a common sheath distal ureterectomy and a bladder cuff, followed by lower pole ureteral reimplantation. Overall, 34 patients with 35 renal units of UTUC in DCS were included and analyzed. To conclude, UTUC of DCS is rare and underreported. Hence, it is difficult to define a standard treatment. Although hemi-NU has been previously described, to the best of our knowledge, this is the first case report of robot-assisted hemi-NU for complete DCS with single-moiety UC.

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Laparoscopic Upper-pole Heminephrectomy for the Management of Duplex Kidney: Outcomes of a Multicenter Cohort

Cited by 7 publications

References 19 publications

Comparative analysis of laparoscopic and open ureteroureterostomy for the treatment of pediatric duplicated kidneys: a clinical efficacy and safety study

Comparative analysis of laparoscopic and open ureteroureterostomy for the treatment of pediatric duplicated kidneys: a clinical efficacy and safety study

Treatment for complete bilateral duplex kidneys with severe hydronephrosis and ureterectasis of the upper moiety in a child: A case report and literature review

Management of Upper Tract Urothelial Carcinoma in a Double Collecting System Kidney

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