Improvement of 1aparoscopic extravesical ureteral nipple reimplantation

Objective To explore the clinical efficacy and operation techniques of 1aparoscopic extravesical ureteral nipple reimplantation. Methods The clinical data of 28 cases with abnormal lower end ureter undergone 1aparoscopic extravesical ureteral nipple reimplantation from August 2013 to June 2017 were reviewed. There were 12 males and 16 females, age from 8 to 48 years, 12 cases on right side, 15 cases on left side and one cases on both sides. Including 22 cases of megaureter, 3 cases of congenital ectopic ureteral orifice and 3 cases of iatrogenic ureteral injuries. Results All operations were successful in the 28 patients without open conversion. The mean operative duration was (96±26, 65-150) minutes.The mean blood loss was (25±8, 10-40) ml. The mean hospital stay was (5.8±1.2, 4-7) days. The preserved time of installing catheter after operation was 1 week. The double J was preserved about 45 days and no anastomotic leakage of urine after surgery. Urinary ultrasonography, urinary computed tomography (CT) were performed after operation. The postoperative follow-up period was 6-24 months. At 3 months postoperation, the hydronephrosis decreased in twenty-five cases and had no obvious change in two cases. But the hydronephrosis exacerbated gradually in one case with anastomotic narrow. Balloon dilatation was performed to solve it eventually. Conclusions Laparoscopic extravesical ureteral nipple reimplantation is safe, efficacious and simplified for abnormal lower end ureter. And this technique is worth to popularize. Key words: Laparoscopy; Ureteral reimplantation; Retrospective analysis