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[Operative correction of primary megaureter in children (author's transl)]
Insights
Congenital megaureter surgery in children showed a 69.23% success rate for ureteroneocystostomy, prioritizing kidney preservation. Careful preoperative assessment and long-term follow-up are crucial for optimal outcomes in pediatric megaureter cases.
Area of Science:
- Pediatric Urology
- Surgical Innovation
- Renal Function Preservation
Context:
- Congenital megaureter affects pediatric patients, necessitating surgical intervention.
- Previous surgical attempts can complicate outcomes.
- Kidney conservation is a key consideration in treatment planning.
Purpose:
- To evaluate the efficacy of surgical correction for congenital megaureter in children.
- To assess the outcomes of bilateral ureteroneocystostomy with submucosal tunneling.
- To identify factors influencing surgical success and failure rates.
Summary:
- Sixty-seven children with congenital megaureter underwent surgical treatment.
- Nephroureterectomy was performed in 12.9% of cases; 55 underwent surgical correction.
- Bilateral ureteroneocystostomy with submucosal tunneling in 23 patients achieved a 69.23% success rate based on urine flow, renal function, and infection absence.
Impact:
- The study highlights the effectiveness of ureteroneocystostomy in managing congenital megaureter, with a notable success rate.
- Liberal surgical indications are supported by the goal of kidney preservation.
- Emphasizes the importance of thorough preoperative evaluation and extended postoperative monitoring for successful management.
Abstract:
Sixty-seven children with congenital megaureter were treated by surgically. Nephroureterectomy was performed in 12 cases (17.9%). Fifty-five children were selected for surgical correction. In 23 patients, a bilateral ureteroneocystostomy with submucosal tunneling was performed. These latter patients were examined in the postoperative period for the following criteria: unobstructed flow urine, improved or stable renal function and absence of infection, 69.23% of these patients met these criteria. Because the primary goal is conservation of the kidney the indication for surgical correction is quite liberal. Thirty percent were failures partially due to previous surgery. The need for detailed preoperative study and long-term follow-up is stressed.