MP44-14 LONG TERM OUTCOMES WITH URETERAL REPLACEMENT USING APPENDIX AND THE YANG-MONTI PRINCIPLE IN PEDIATRIC PATIENTS

Abstract

You have accessJournal of UrologyPediatric Urology II (MP44)1 Sep 2021MP44-14 LONG TERM OUTCOMES WITH URETERAL REPLACEMENT USING APPENDIX AND THE YANG-MONTI PRINCIPLE IN PEDIATRIC PATIENTS Diana M Lopategui, Daniel E Nassau, German Quevedo, Santa Cruz Bolivia, Juan Moldes, Juan P Corbetta, Buenos Aires Argentina, Alireza Alam, Rafael Gosalbez, and Miguel A Castellan Diana M LopateguiDiana M Lopategui More articles by this author , Daniel E NassauDaniel E Nassau More articles by this author , German QuevedoGerman Quevedo More articles by this author , Santa Cruz BoliviaSanta Cruz Bolivia More articles by this author , Juan MoldesJuan Moldes More articles by this author , Juan P CorbettaJuan P Corbetta More articles by this author , Buenos Aires ArgentinaBuenos Aires Argentina More articles by this author , Alireza AlamAlireza Alam More articles by this author , Rafael GosalbezRafael Gosalbez More articles by this author , and Miguel A CastellanMiguel A Castellan More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002065.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Long segment ureteral defects are a management dilemma, often requiring renal auto-transplantation or intestinal substitution. There is a paucity of long-term data for appendiceal or reconfigured intestinal ureteral substitution in Pediatric patients, limited mostly to case reports. We hypothesized that appendiceal or reconfigured bowel ureteral substitution is safe with long-lasting successful outcomes. METHODS: This is a multi-institutional retrospective review of patients who underwent appendiceal or reconfigured bowel ureteral substitution. Patients were identified via medical records from different institutions in the United States and Latin America. We excluded patients over 18 years of age at the time of surgery or with less than 3 months of follow-up. Demographics and clinical characteristics were collected and descriptive statistics were used for both categorical and nominal variables. RESULTS: Since 2010, 6 patients underwent appendiceal or reconfigured bowel ureteral substitution at 5 different institutions. Clinical characteristics are summarized in Table 1. Median age at surgery was 5 years (range 16-192 months) with a median follow-up time of 43 months (11-78). Appendiceal substitution was used in right ureter (3), in left transplanted kidney ureter (2) and, reconfigured colon segment in left ureter (1). Etiologies of ureteral lesions were all iatrogenic in nature. The ureteral defect lengths were all >6cm, and 1 patient had mid-ureteral appendix interposition. All patients had improvement or maintenance of pre-operative renal function. All patients had resolution (3) or improvement (3) in hydronephrosis by SFU grade. No patient needed additional related surgery. CONCLUSIONS: This retrospective case-series demonstrates that the use of appendiceal or reconfigured bowel ureteral substitution is a suitable option in pediatric patients with long ureteral defects. Also suggests that these segments are safe and durable in ureteral reconstruction, as it was used in a variety of clinical scenarios with good long-term outcomes. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e798-e798 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Diana M Lopategui More articles by this author Daniel E Nassau More articles by this author German Quevedo More articles by this author Santa Cruz Bolivia More articles by this author Juan Moldes More articles by this author Juan P Corbetta More articles by this author Buenos Aires Argentina More articles by this author Alireza Alam More articles by this author Rafael Gosalbez More articles by this author Miguel A Castellan More articles by this author Expand All Advertisement Loading ...