摘要
Introduction:The main goal of managing an obstructed megaureter(OMU)is to preserve the function of the affected kidney.To preserve the upper urinary tract,end cutaneous ureterostomy(ECU)seems to be a promising temporizing option.We aimed to evaluate our experience with ECU in patients with primary and secondary OMU and to demonstrate an efficacy of robot-assisted laparoscopic takedown ureterostomy and subsequent extravesical ureteric reimplantation.Materials and methods:Retrospective analysis of patients that underwent ECU due to primary or secondary megaureter between 2003 and 2020.Nineteen patients(12 males,7 females)with a mean age of 4.2±3.5 months(mean±standard deviation)underwent ECU of 27 renal units.Of those,11(57.9%)had primary OMU and 8(42.1%)had secondary OMU.Undiversion was performed in 16(84%)out of 19 patients(20 renal units out of 27[74%]).Results:In the vast majority of the cases,we have observed improvement in the hydronephrosis and renal function after ureterostomy.After reimplantation ultrasonography showed either stable or further improvement in hydronephrosis in 80%of patients.Robot-assisted laparoscopic patients had shorter admission period and indwelling catheter time after the surgery.Conclusions:End cutaneous ureterostomy is a safe and effective temporary procedure for the treatment of progressive primary and secondary megaureters.Robot-assisted laparoscopic takedown of ureterostomy with subsequent reimplantation seems to be a good alternative for undiversion and subsequent reimplantation in these patients.
