Frontiers in pediatrics · 2026
Pneumovesicoscopic ureteral reimplantation for pediatric vesicoureteral reflux: Politano-Leadbetter vs. Cohen technique.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Huang Mingliu, Zhang Ting, Wang Chao, Dai Shu, Xia Hongliang, Cao Xu, Fu Mingcui, Yan Xiangming, Bi Yunli, Zhou Yun
Аннотация
PURPOSE: To investigate and compare the clinical efficacy of pneumovesicoscopic Politano-Leadbetter and Cohen ureteral reimplantation for primary vesicoureteral reflux (VUR) in children.
METHODS: We retrospectively reviewed 179 children with primary VUR (high-risk grade III and grades IV-V) who underwent pneumovesicoscopic ureteral reimplantation at our institution between October 2021 and January 2024. Patients were allocated to the Politano-Leadbetter group (Group P, n = 97) or the Cohen group (Group C, n = 82), including 120 unilateral and 59 bilateral cases. Perioperative parameters and postoperative complications were compared over a 6-30 month follow-up period.
RESULTS: All procedures were completed pneumovesicoscopically without conversion to open surgery. In unilateral cases, there were no significant between-group differences in operative time (119.85 ± 29.13 vs. 116.21 ± 22.04 min, p = 0.437), estimated blood loss (6.15 ± 0.98 vs. 6.02 ± 0.91 mL, p = 0.454), duration of urethral catheterization (4.31 ± 0.59 vs. 4.53 ± 0.85 days, p = 0.112), length of hospital stay (6.34 ± 1.71 vs. 6.42 ± 0.93 days, p = 0.745), or complication rate (7.5% vs. 15.1%, p = 0.217). Similar findings were observed for bilateral cases (all p > 0.05). Surgical failure occurred in 2 ureters in Group P and 3 ureters in Group C, the imaging-confirmed anatomical success rate was 98.1% in Group P and 96.3% in Group C.
CONCLUSION: Pneumovesicoscopic ureteral reimplantation is a safe and effective minimally invasive approach for pediatric VUR in the short term. Although the Politano-Leadbetter technique is technically more demanding, it provides a more physiological ureteral course. Long-term outcomes require further validation.
METHODS: We retrospectively reviewed 179 children with primary VUR (high-risk grade III and grades IV-V) who underwent pneumovesicoscopic ureteral reimplantation at our institution between October 2021 and January 2024. Patients were allocated to the Politano-Leadbetter group (Group P, n = 97) or the Cohen group (Group C, n = 82), including 120 unilateral and 59 bilateral cases. Perioperative parameters and postoperative complications were compared over a 6-30 month follow-up period.
RESULTS: All procedures were completed pneumovesicoscopically without conversion to open surgery. In unilateral cases, there were no significant between-group differences in operative time (119.85 ± 29.13 vs. 116.21 ± 22.04 min, p = 0.437), estimated blood loss (6.15 ± 0.98 vs. 6.02 ± 0.91 mL, p = 0.454), duration of urethral catheterization (4.31 ± 0.59 vs. 4.53 ± 0.85 days, p = 0.112), length of hospital stay (6.34 ± 1.71 vs. 6.42 ± 0.93 days, p = 0.745), or complication rate (7.5% vs. 15.1%, p = 0.217). Similar findings were observed for bilateral cases (all p > 0.05). Surgical failure occurred in 2 ureters in Group P and 3 ureters in Group C, the imaging-confirmed anatomical success rate was 98.1% in Group P and 96.3% in Group C.
CONCLUSION: Pneumovesicoscopic ureteral reimplantation is a safe and effective minimally invasive approach for pediatric VUR in the short term. Although the Politano-Leadbetter technique is technically more demanding, it provides a more physiological ureteral course. Long-term outcomes require further validation.