Effect of Pneumovesicoscopic Cohen Surgery with Adjustable Suspension Technique Through the Urethra on the Treatment of Primary Vesicoureteral Reflux Disease in Infants

Overview

Journal BMC Surg

Publisher Biomed Central

Specialty General Surgery

Date 2023 Apr 28

PMID 37118712

Authors

Xu Cui

Wen-Hua Huang

Yun-Jin Wang

Liu Chen

Jian-Qin Zhang

Chao-Ming Zhou

Affiliations

Soon will be listed here.

Abstract

Objective: The objective of this study was to evaluate the safety and efficacy of pneumovesicoscopic Cohen surgery with an adjustable suspension technique through the urethra for the treatment of primary vesicoureteral reflux disease in infants.

Methods: This study retrospectively analysed the clinical data of 31 infants who underwent pneumovesicoscopic Cohen surgery with an adjustable suspension technique through the urethra in our hospital from January 2019 to December 2020. We also collected the clinical data of 29 infants who underwent open Cohen surgery in our hospital from January 2015 to December 2018 as a control variable. The clinical efficacy of the two groups was compared.

Result: All pneumovesicoscopic Cohen surgeries were successfully completed and no patients were converted to open surgery. The amount of bleeding, duration of postoperative analgesia, duration of postoperative haematuria, incision size and length of hospital stay in the pneumovesicoscopic surgery group were significantly lower than those in the open surgery group (P < 0.05). The operation time of the pneumovesicoscopic surgery group was significantly longer than that of the open surgery group (P < 0.05). Both groups were followed for six months after surgery. At the 6-month follow-up time, there were no significant differences in the degree of hydronephrosis, renal scarring, renal atrophy, glomerular filtration rate, or KIM-1 and MCP-1 expression between the two groups (P > 0.05).

Conclusion: Pneumovesicoscopic Cohen surgery with an adjustable suspension technique through the urethra for the treatment of primary vesicoureteral reflux disease in infants was safe and effective. This procedure had the advantages of less trauma, quick recovery and good cosmetic effects.

References

Baek M, Han D . Transvesicoscopic Politano-Leadbetter ureteral reimplantation in children with vesicoureteral reflux: A novel surgical technique. Investig Clin Urol. 2019; 60(5):405-411. PMC: 6722406. DOI: 10.4111/icu.2019.60.5.405. View

Loukogeorgakis S, Burnand K, MacDonald A, Wessely K, De Caluwe D, Rahman N . Renal scarring is the most significant predictor of breakthrough febrile urinary tract infection in patients with simplex and duplex primary vesico-ureteral reflux. J Pediatr Urol. 2020; 16(2):189.e1-189.e7. DOI: 10.1016/j.jpurol.2019.11.018. View

Fonseca F, Tanno F, Nguyen H . Current options in the management of primary vesicoureteral reflux in children. Pediatr Clin North Am. 2012; 59(4):819-34. DOI: 10.1016/j.pcl.2012.05.012. View

Yeung C, Chowdhary S, Sreedhar B . Minimally Invasive Management for Vesicoureteral Reflux in Infants and Young Children. Clin Perinatol. 2017; 44(4):835-849. DOI: 10.1016/j.clp.2017.08.008. View

Yeung C, Sihoe J, Borzi P . Endoscopic cross-trigonal ureteral reimplantation under carbon dioxide bladder insufflation: a novel technique. J Endourol. 2005; 19(3):295-9. DOI: 10.1089/end.2005.19.295. View

Sargent M . What is the normal prevalence of vesicoureteral reflux?. Pediatr Radiol. 2000; 30(9):587-93. DOI: 10.1007/s002470000263. View

Kanojia R, Pandey A, Bawa M . Robotic Assisted Vesicoscopic Cohen's Reimplantation in Pediatric Patient: Nuances of Technique, Experience, and Outcome. J Laparoendosc Adv Surg Tech A. 2020; 30(10):1137-1141. DOI: 10.1089/lap.2020.0401. View

Morozova O, Morozov D, Pervouchine D, Einav Y, Lakomova D, Zakharova N . Urinary biomarkers of latent inflammation and fibrosis in children with vesicoureteral reflux. Int Urol Nephrol. 2019; 52(4):603-610. DOI: 10.1007/s11255-019-02357-1. View

Chang J, Zhang Q, Hou P, Wang D, Li A, Lv X . Comparative Clinical Study Between Modified Ureteral Orthotopic Reimplantation and Cohen Method Under Pneumovesicum in Pediatric Patients With Hydroureteronephrosis. Front Pediatr. 2020; 8:62. PMC: 7068794. DOI: 10.3389/fped.2020.00062. View

10.

Parmaksiz G, Noyan A, Dursun H, Ince E, Anarat R, Cengiz N . Role of new biomarkers for predicting renal scarring in vesicoureteral reflux: NGAL, KIM-1, and L-FABP. Pediatr Nephrol. 2015; 31(1):97-103. DOI: 10.1007/s00467-015-3194-3. View

11.

Blais A, Bolduc S, Moore K . Vesicoureteral reflux: From prophylaxis to surgery. Can Urol Assoc J. 2017; 11(1-2Suppl1):S13-S18. PMC: 5332225. DOI: 10.5489/cuaj.4342. View

12.

Skoog S, Peters C, Arant Jr B, Copp H, Elder J, Hudson R . Pediatric Vesicoureteral Reflux Guidelines Panel Summary Report: Clinical Practice Guidelines for Screening Siblings of Children With Vesicoureteral Reflux and Neonates/Infants With Prenatal Hydronephrosis. J Urol. 2010; 184(3):1145-51. DOI: 10.1016/j.juro.2010.05.066. View

13.

Mina-Riascos S, Fernandez N, Garcia-Perdomo H . Effectiveness and risks of endoscopic management compared to vesicoureteral reimplantation in patients with high-grade vesicoureteral reflux: systematic review and network meta-analysis. Eur J Pediatr. 2021; 180(5):1383-1391. DOI: 10.1007/s00431-021-03948-w. View

14.

Wang H, Tejwani R, Cannon Jr G, Gargollo P, Wiener J, Routh J . Open versus minimally invasive ureteroneocystostomy: A population-level analysis. J Pediatr Urol. 2016; 12(4):232.e1-6. PMC: 5012942. DOI: 10.1016/j.jpurol.2016.03.014. View

15.

Kurtz M, Leow J, Varda B, Logvinenko T, Yu R, Nelson C . Robotic versus open pediatric ureteral reimplantation: Costs and complications from a nationwide sample. J Pediatr Urol. 2016; 12(6):408.e1-408.e6. DOI: 10.1016/j.jpurol.2016.06.016. View

16.

Tekgul S, Riedmiller H, Hoebeke P, Kocvara R, Nijman R, Radmayr C . EAU guidelines on vesicoureteral reflux in children. Eur Urol. 2012; 62(3):534-42. DOI: 10.1016/j.eururo.2012.05.059. View

17.

Mattoo T . Vesicoureteral reflux and reflux nephropathy. Adv Chronic Kidney Dis. 2011; 18(5):348-54. PMC: 3169795. DOI: 10.1053/j.ackd.2011.07.006. View

18.

Kuma A, Tamura M, Otsuji Y . [Mechanism of and Therapy for Kidney Fibrosis]. J UOEH. 2016; 38(1):25-34. DOI: 10.7888/juoeh.38.25. View

19.

Valerio F, Lemos R, de C Reis A, Pimenta L, Vieira E, E Silva A . Biomarkers in vesicoureteral reflux: an overview. Biomark Med. 2020; 14(8):683-696. DOI: 10.2217/bmm-2019-0378. View

20.

Chung K, Sihoe J, Liu K, Chao N, Hung J, Liu C . Surgical Outcome Analysis of Pneumovesicoscopic Ureteral Reimplantation and Endoscopic Dextranomer/Hyaluronic Acid Injection for Primary Vesicoureteral Reflux in Children: A Multicenter 12-Year Review. J Laparoendosc Adv Surg Tech A. 2017; 28(3):348-353. DOI: 10.1089/lap.2017.0281. View