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Single-surgeon experience with transvesicoscopic ureteral reimplantation in children with vesicoureteral reflux

Authors
 Chang Hee Hong ; Jang Hwan Kim ; Sang Won Han ; Young Jae Im ; Hyun Jin Jung 
Citation
 Urology, Vol.77(6) : 1465~1469, 2011 
Journal Title
 Urology 
ISSN
 0090-4295 
Issue Date
2011
Abstract
OBJECTIVES: To review our initial experience with transvesicoscopic ureteral reimplantation (TVUR) in children with vesicoureteral reflux and to evaluate the learning curve for the feasibility and reproducibility of TVUR. METHODS: TVUR was performed in 28 consecutive patients with a mean age of 6.0 years. Cohen's classic technique was reproduced using a laparoscopic technique with two 3-mm working ports and a 5-mm camera port. RESULTS: TVUR was successfully completed in 26 patients. In 2 patients, TVUR was converted to open intravesical reimplantation. The postoperative vesicoureteral reflux resolution rate was 94.6% (35 of 37 ureters). The mean operative time for TVUR was 166 minutes for unilateral reimplantation and 189 minutes for bilateral reimplantation. When the operation times of the first 13 and the last 13 patients were compared, the mean operative time had decreased significantly for the last 13 patients compared to that for the first 13 patients (140 vs 220 minutes). The mean postoperative hospital stay was also significantly shorter for the last 13 patients than for the first 13 patients (1.08 vs 1.69 days). CONCLUSIONS: TVUR is currently performed at only at a few centers because of the technical difficulties and the potentially steep learning curve. However, our results have indicated rapid improvement in the operative time within a short period, suggesting a shorter learning curve for TVUR than expected. TVUR is a reproducible procedure and is a reasonable option for the treatment of vesicoureteral reflux.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/93214
DOI
10.1016/j.urology.2010.11.023
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Urology
Yonsei Authors
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Link
 http://www.sciencedirect.com/science/article/pii/S0090429510020108
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