Surgical Management of Vesicoureteral Junction Obstruction in Children: A Comparative Study Between Transvesicoscopic Cohen Reimplantation and Transumbilical Laparoendoscopic Single-Site Lich-Gregoir Techniques.

Abstract

Background: There are many reports on the application of minimally invasive technology in correction of children's vesicoureteral junction obstruction (VUJO), but there is no report on the treatment of children's VUJO with the transumbilical laparoendoscopic single-site surgery (TU-LESS) Lich-Gregoir method. We aimed to comparatively analyze the therapeutic outcomes of transvesicoscopic ureteral reimplantation Cohen (TUR-C) procedure and TU-LESS Lich-Gregoir (TU-LESS-LG) procedure in pediatric VUJO. Materials and Methods: The data of 49 children with VUJO, admitted from January 2016 to January 2020, were retrospectively analyzed. Based on different surgical methods, they were divided into the TUR-C group (23 cases) and the TU-LESS-LG group (26 cases). Demographic characteristics, perioperative characteristics, postoperative complications, recovery of renal function, and improvement of hydronephrosis were compared between the two groups. Results: There were no statistical differences in demographic characteristics and preoperative data between the two groups. The TU-LESS-LG group was superior to the TUR-C group in terms of average operation time and postoperative hospital stay. There was no statistical difference between the two groups in terms of postoperative complications, postoperative recovery of renal function, and improvement of hydronephrosis. Conclusions: The two surgical methods can achieve a similar curative effect in the treatment of VUJO. The TU-LESS-LG procedure has more advantages of operation time, postoperative hospital stay, wider age range for selection of cases, megaureter tapering, and cosmetic incision, but the operation is more difficult. Clinical Trial Registration number: 2021(KY-E-048).