Efficacy of pneumocystoscopic Cohen ureteric reimplantation for congenital malformation of vesicoureteral junction obstruction / 中华实用儿科临床杂志

ABSTRACT

Objective To explore the efficacy of Cohen ureteric reimplantation for congenital malformation of vesicoureteral junction in children.Methods From February 2014 to August 2016,12 children with congenital monstrositas of vesicoureteral junction obstruction who were treated with pneumoeystoscopic Cohen ureteric reimplantation in Guizhou Provincial People's Hospital were selected.In these cases,8 males and 4 females,their ages ranged from 2 months past 1 year to 11 years,and the average age was 5.26 years.In the 12 patients,there were 6 cases with left vesicoureteral junction obstruction,and 1 case with right vesicoureteral junction obstruction,1 case with left ureter cyst and duplication of ureter ectopic opening,1 case with right duplex kidney and ureter cyst,1 case with right primary vesicoureteric reflux and left vesicoureteral junction obstruction,2 cases with bilateral primary vesicoureteric reflux and 1 case with ureter cyst.A foley catheter and ureteral stent was indwelled in each patient but no bladder fistula was made.All of the patients underwent pneumocystoscopic Cohen ureteric reimplantation.The stenting catheters were removed in 1-3 months after surgery.B ultrasonography was used to follow the degree of the dilatation of ureter and hydronephrosis.Urinalysis was conducted to detect the urinary tract infection.Intravenous urography examination was conducted to detect anastomotic stenosis.Voiding cystourethrography was performed to show ureteral reflux.Results All procedures were accomplished without conversion.The duration of operations ranged from 100 to 330 min (mean 207 min).All patients were followed up for 3 to 10 months,but no urinary tract infection and anastomotic obstruction occurred,and B ultrasonography showed that hydronephrosis or dilatation of ureter were improved in different degrees or disappeared.Two cases of ureteral reflux occurred in the early follow-up,and these cases recovered after being given symptomatic treatment.Conclusions The pneumocystoscopic Cohen ureteric reimplantation is a safe and effective option for congenital malformation of vesicoureteral junction in children.