11-12 JANUARY 2024, TASHKENT, UZBEKISTAN
5
PNEUMOVESICOSCOPIC VS LAPAROSCOPIC REIMPLANTATION
OF THE URETER: COMPARATIVE ANALYSIS
Agzamhodjayev S.T., Rahmatullayev A.A., Abdullayev Z.B.,
Ergashev K.T., Hidoyatov K.Z., Soliyev A.T., Eshonqulov S.G.
National Children’s Medical Center
Tashkent, Uzbekistan
Background.
Numerous studies have documented the use of minimally invasive technologies to
treat pediatric vesicoureteral reflux (VUR). In this paper, our goal was to compare the therapeutic
results of pneumovesicoscopic (PVUR first group) and laparoscopic extravesical ureteral
reimplantation (LEVUR second group) operations.
Material and methods.
34 children's admission records were examined retrospectively from
January 2021 to January 2023. The age of the patients in PVUR was 13-205 mo; in LEVUR 10-102
mo. Girls/boys were 12/6 and 8/8 in the first and second groups, respectively. Patients were split
into the laparoscopic extravesical group (16 patients; 16 ureters) and the pneumovesicoscopic group
(18 patients; 33 ureters). Indications for operative management were vesicoureteral
reflux/obstruction with/without diverticulum, and duplex system with/without ureterocele.
Operation methods applied in PVUR were Politono-Leadbetter (for unilateral cases) and Cohen
transtrigonal (for bilateral cases); in LEVUR for all cases, extravesical Lich-Gregoir was performed.
A comparison was made between the two groups' demographics, perioperative features,
postoperative complications, length of operation, time to discharge, success rate, and complication
rate.
Results.
The two groups had no statistical differences in demographic characteristics and
preoperative data. The PVUR group was superior to the LEVUR group in terms of average operation
time (for unilateral cases 187 and 287 mins, respectively) and hospital stay (7.1 and 9.4 days,
respectively). There was no statistical difference between the two groups regarding postoperative
complications (2 [11%] for PVUR and 1 [12.5%] for LEVUR) and success rate (30/33 [90.9%] in first
group and 14/16 [87.5%] in the second group).
Conclusion.
When treating VUR, the two surgical techniques can have comparable therapeutic
effects. The PVUR treatment requires a longer learning curve but offers greater benefits in terms of
operation duration, hospital stay, bilateral cases, and cosmetic incision.
References:
1.
Зубань, О. Н., Муравьев, А. Н., Рашидов, З. Р., Семченко, А. Ф., & Чотчаев, Р. М. (2012).
Кишечная пластика мочеточников при протяженных поражениях туберкулезного или
иного генеза. Вестник хирургии им. ИИ Грекова, 1, 122-123.
2.
Agzamkhodjaev, S. T., Abdullaev, Z. B., Terebaev, B. A., & Nosirov, A. А. (2019).
STRUCTURAL CHANGES OF URETEROPELVIC JUNCTION IN CHILDREN WITH
CONGENITAL HYDRONEPHROSIS. Central Asian Journal of Pediatrics, 2(1), 169-171.
