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Laparoscopic retroperitoneal approach for retrocaval ureter in children

  • Matthieu PeycelonEmail author
  • Grégory Rembeyo
  • Anca Tanase
  • Cécile Olivia Muller
  • Thomas Blanc
  • Hamdan Alhazmi
  • Annabel Paye-Jaouen
  • Alaa El Ghoneimi
Original Article
  • 10 Downloads

Abstract

Purpose

Retrocaval ureter (RCU) is a rare congenital anomaly and published data on pediatric laparoscopic management are poor. The aim of this study was to report our experience of retroperitoneal laparoscopic approach for management of RCU in children.

Methods

A retrospective review of data from patients treated for RCU between 2002 and 2018 in our institution was performed. All patients were positioned in a flank position and underwent a three-port (5-mm optical trocar and two 3-mm trocars) laparoscopic retroperitoneal ureteroureterostomy. Anastomosis was made by 6/0 absorbable sutures. A JJ stent was always inserted.

Results

Five patients with a median age of 94 months (5–152) were operated on and followed up for a median time of 103 months (46–201). Median operating time was 200 min (160–270). No conversion and no transfusion occurred. Median hospital stay was 2 days (1–4). Ureteral stent was removed after 52 days (47–82). Complications included pyelonephretis (N = 1). In all cases, hydronephrosis decreased postoperatively.

Conclusions

Retroperitoneal laparoscopic approach for RCU is safe and effective in children. Our video demonstrates different patients with specific surgical details to show how to manage these children. The global vision of the upper tract by laparoscopy leads to optimal management of these children even if the anomaly was not detected preoperatively.

Keywords

Retrocaval ureter Hydronephrosis Multimodal imaging Retroperitoneal space Laparoscopy Child 

Abbreviations

ANT

Antenatal diagnosis

CT

Computerized tomography

Diag

Diagnosis

DRF

Differential renal function

F

Female

FU

Follow-up

GV

Gonadal vein

Hem.

Hematuria

Int.

Interrupted sutures

IVC

Inferior vena cava

IVP

Intravenous pyelography

kg

Kilogram

LOS

Length of stay

Lith

Lithiasis

M

Male

MAG3

Mercaptoacetyltriglycine

Mg dL−1

Milligram per deciliter

mm

Millimeter

MRI

Magnetic resonance imaging

N

Number

ND

Not described

OT

Operative time

Postop

Postoperative

PP

Pyelopyelostomy

Preop

Preoperative

PU

Pyeloureterostomy

PUJ(O)

Pelvi-ureteric junction (obstruction)

RCU

Retrocaval ureter

RGP

Retrograde pyelography

RP

Retroperitoneal laparoscopic

Run

Running suture

RUS

Renal ultrasonography

Sympt

Symptoms

TP

Transperitoneal laparoscopic

UTI

Urinary tract infection

UU

Ureteroureterostomy

Notes

Author contributions

MP: project development, data management, data analysis, manuscript writing. GR: project development, data collection. AT: data management, manuscript writing. COM: data collection, data analysis. TB: manuscript editing. HA: manuscript editing. AP-J: project development, data management, manuscript editing. AE-G: project development, data analysis, manuscript writing and editing.

Compliance with ethical standards

Ethical approval

This study had received Robert-Debré University Hospital review board approval. No help or financial support from any industrial firm has been declared. We have received a signed release form from the patient’s families authorizing this publication.

Conflict of interest

All authors declare the following: Payment/services info: all authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous 3 years with any organizations that might have an interest in the submitted work. Other relationships: all authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Supplementary material

Supplementary material 1 (M4V 139146 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Pediatric Surgery and UrologyRobert-Debré University Children’s Hospital, Assistance-Publique Hôpitaux de Paris, University Paris Diderot, Sorbonne Paris CitéParisFrance
  2. 2.Reference Center for Rare Diseases (CRMR) Malformations Rares des Voies Urinaires (MARVU)ParisFrance
  3. 3.Department of RadiologyRobert-Debré University Children’s Hospital, Assistance-Publique Hôpitaux de Paris, University Paris Diderot, Sorbonne Paris CitéParisFrance

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