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Technical Modification of the Terminal Ureter During Total Transperitoneal Laparoscopic Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma
06:39

Technical Modification of the Terminal Ureter During Total Transperitoneal Laparoscopic Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma

Published on: November 22, 2019

Ureteral reconstruction for retroperitoneal tumors in children

Daniel N Rutigliano1, Anthony Georges, Suzanne L Wolden

  • 1Division of Pediatric Surgery, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10021, USA.

Journal of Pediatric Surgery
|February 3, 2007
PubMed

Insights

Ureteral reconstruction after pelvic and abdominal tumor resection or stricture is feasible in pediatric oncology patients. Surgical repair can preserve renal function and improve outcomes, with no tumor recurrence or renal complications observed in this study.

Area of Science:

  • Pediatric Oncology
  • Urology
  • Surgical Reconstruction

Background:

  • Pelvic and abdominal tumors can involve ureteral segments, necessitating resection.
  • Ureteral strictures may arise as a consequence of intensive cancer therapy.
  • Urinary reconstruction is crucial for preserving renal function in affected pediatric patients.

Purpose of the Study:

  • To present the experience with urinary reconstruction in pediatric oncology patients with ureteral involvement due to tumors or strictures.
  • To evaluate the efficacy and outcomes of ureteral reconstructive procedures in this patient cohort.
  • To assess the impact of reconstruction on renal function and oncologic control.

Main Methods:

  • Retrospective review of pediatric oncology patients undergoing ureteral reconstruction for solid abdominal/pelvic tumors.
  • Data collection included diagnosis, surgical procedures, renal function parameters, and follow-up status.
  • Follow-up assessments involved serum urea nitrogen/creatinine levels and renal scans.

Main Results:

  • Thirteen pediatric patients (8 male, 5 female; mean age 10.1 years) were identified.
  • Common indications included en bloc tumor resection (n=8) and ureteral strictures (n=3).
  • Boari flap, Leadbetter-Politano reimplantation, and psoas hitch were frequent procedures; 2 patients had elevated renal function markers, and no renal complications or tumor recurrences were noted.

Conclusions:

  • Ureteral involvement in abdominal and pelvic tumors requires reconstructive surgery for complete tumor resection and improved survival.
  • Ureteral reconstruction effectively preserves renal function in pediatric patients with post-therapy strictures.
  • Surgical management of ureteral compromise in pediatric oncology is associated with favorable oncologic and renal outcomes.
Abstract

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