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Prem Puri - One of the best experts on this subject based on the ideXlab platform.
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Fate of the Retained Ureteral Stump After Upper Pole Heminephrectomy in Duplex Kidneys
The Journal of urology, 2002Co-Authors: Diane De Caluwé, Boris Chertin, Prem PuriAbstract:Purpose: We review the long-term outcome of retained ureteral stumps in children undergoing Heminephrectomy for nonfunctioning upper pole moieties in duplex kidneys.Materials and Methods: The medical records of 50 patients who underwent 50 upper pole heminephrectomies for a nonfunctioning upper pole moiety of a duplex kidney between January 1990 and December 2000 were reviewed retrospectively.Results: Median patient age at Heminephrectomy was 2.5 years (range 3 weeks to 16.5 years) and median followup was 6 years (range 1 to 11). Indications for Heminephrectomy in the 50 renal units were obstructive ureterocele in 25 (50%) cases, ectopic ureter in 15 (30%), obstructive megaloureter in 5 (10%) and reflux nephropathy in 5 (10%). A total of 48 (96%) of the corresponding ureters were taken down as low as possible and transfixed through the Heminephrectomy incision. Residual stump excision was required in 5 (10%) of the 50 units for recurrent urinary tract infection due to vesicoureteral reflux.Conclusions: Ou...
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Long-term outcome of the retained ureteral stump after lower pole Heminephrectomy in duplex kidneys.
European urology, 2002Co-Authors: Diane De Caluwé, Boris Chertin, Prem PuriAbstract:Abstract Objectives: Duplication of the ureter and renal pelvis is the most common upper urinary tract anomaly in childhood. The anatomical and functional divisions between upper and lower moieties of duplex kidney are extremely variable. The underlying pathological condition associated with a lower moiety is usually massive vesicoureteral reflux (VUR) to the lower collecting system and only rare obstruction. The non-functioning upper moiety is usually associated with obstructive ectopic ureter (with or without ureterocele). Most lower pole heminephrectomies are carried out for non-functioning lower moieties. In most cases, the lower defunctionalised segment of the ureter is left in situ. Complete ureterectomy is usually performed if presence of VUR into the lower end of the corresponding ureter is shown. There is little information on the long-term outcome of residual ureteral ‘stumps'. The purpose of our study was to review the long-term outcome of retained ureteral stumps in children undergoing Heminephrectomy for non-functioning lower pole moieties in duplex kidneys. Materials and Methods: The medical records of 19 patients who underwent 20 lower pole heminephrectomies for a non-functioning lower pole moiety of a duplex kidney between January 1990 and December 2000 were reviewed retrospectively. Median age at Heminephrectomy was 4.5 years (range: 1 month to 12 years). Indications for Heminephrectomy in the 20 renal units was reflux nephropathy in 16 (80%) and obstructive nephropathy in 4 (20%). All corresponding ureters were taken down as low as possible and transfixed through the Heminephrectomy incision. Median follow-up was 8.5 years (range: 1–11 years). Results: Eight (40%) showed VUR into the stump after lower pole Heminephrectomy. Two of these underwent subureteral endoscopic correction of VUR with polytetrafluoroethylene paste and resection of the stump was carried out in remaining two patients for recurrent urinary tract infections (UTI). Remaining four of the eight patients demonstrated spontaneous resolution of VUR during follow-up. Conclusions: Our data suggest that the vast majority of patients with residual ureteral stumps after lower pole Heminephrectomy do not require stump resection at long-term follow-up.
Diane De Caluwé - One of the best experts on this subject based on the ideXlab platform.
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Fate of the Retained Ureteral Stump After Upper Pole Heminephrectomy in Duplex Kidneys
The Journal of urology, 2002Co-Authors: Diane De Caluwé, Boris Chertin, Prem PuriAbstract:Purpose: We review the long-term outcome of retained ureteral stumps in children undergoing Heminephrectomy for nonfunctioning upper pole moieties in duplex kidneys.Materials and Methods: The medical records of 50 patients who underwent 50 upper pole heminephrectomies for a nonfunctioning upper pole moiety of a duplex kidney between January 1990 and December 2000 were reviewed retrospectively.Results: Median patient age at Heminephrectomy was 2.5 years (range 3 weeks to 16.5 years) and median followup was 6 years (range 1 to 11). Indications for Heminephrectomy in the 50 renal units were obstructive ureterocele in 25 (50%) cases, ectopic ureter in 15 (30%), obstructive megaloureter in 5 (10%) and reflux nephropathy in 5 (10%). A total of 48 (96%) of the corresponding ureters were taken down as low as possible and transfixed through the Heminephrectomy incision. Residual stump excision was required in 5 (10%) of the 50 units for recurrent urinary tract infection due to vesicoureteral reflux.Conclusions: Ou...
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Long-term outcome of the retained ureteral stump after lower pole Heminephrectomy in duplex kidneys.
European urology, 2002Co-Authors: Diane De Caluwé, Boris Chertin, Prem PuriAbstract:Abstract Objectives: Duplication of the ureter and renal pelvis is the most common upper urinary tract anomaly in childhood. The anatomical and functional divisions between upper and lower moieties of duplex kidney are extremely variable. The underlying pathological condition associated with a lower moiety is usually massive vesicoureteral reflux (VUR) to the lower collecting system and only rare obstruction. The non-functioning upper moiety is usually associated with obstructive ectopic ureter (with or without ureterocele). Most lower pole heminephrectomies are carried out for non-functioning lower moieties. In most cases, the lower defunctionalised segment of the ureter is left in situ. Complete ureterectomy is usually performed if presence of VUR into the lower end of the corresponding ureter is shown. There is little information on the long-term outcome of residual ureteral ‘stumps'. The purpose of our study was to review the long-term outcome of retained ureteral stumps in children undergoing Heminephrectomy for non-functioning lower pole moieties in duplex kidneys. Materials and Methods: The medical records of 19 patients who underwent 20 lower pole heminephrectomies for a non-functioning lower pole moiety of a duplex kidney between January 1990 and December 2000 were reviewed retrospectively. Median age at Heminephrectomy was 4.5 years (range: 1 month to 12 years). Indications for Heminephrectomy in the 20 renal units was reflux nephropathy in 16 (80%) and obstructive nephropathy in 4 (20%). All corresponding ureters were taken down as low as possible and transfixed through the Heminephrectomy incision. Median follow-up was 8.5 years (range: 1–11 years). Results: Eight (40%) showed VUR into the stump after lower pole Heminephrectomy. Two of these underwent subureteral endoscopic correction of VUR with polytetrafluoroethylene paste and resection of the stump was carried out in remaining two patients for recurrent urinary tract infections (UTI). Remaining four of the eight patients demonstrated spontaneous resolution of VUR during follow-up. Conclusions: Our data suggest that the vast majority of patients with residual ureteral stumps after lower pole Heminephrectomy do not require stump resection at long-term follow-up.
Andrew Labbie - One of the best experts on this subject based on the ideXlab platform.
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transperitoneal and retroperitoneal laparoscopic Heminephrectomy what approach for which patient
The Journal of Urology, 2006Co-Authors: Miguel Castellan, Rafael Gosalbez, A.j. Carmack, J.c. Prieto, Marcos Perezbrayfield, Andrew LabbieAbstract:Purpose: We report our experience with laparoscopic Heminephrectomy using the transperitoneal and retroperitoneal approaches in 48 pediatric patients.Materials and Methods: A total of 48 laparoscopic heminephrectomies were performed in 35 girls and 13 boys 45 days to 17 years old (mean 4.08 years) between September 1998 and March 2005. The procedures consisted of 44 upper pole heminephrectomies with partial or total ureterectomies and 4 lower pole heminephroureterectomies. Surgeries were performed using a transperitoneal approach in 32 patients (67%) and a retroperitoneal approach in 16 (33%).Results: Followup ranged from 0.75 to 7.25 years (mean 3.53). In the retroperitoneal group 2 procedures required conversion, 1 to open Heminephrectomy and 1 to a transperitoneal laparoscopic approach. Complications were seen in 5 of 48 patients (10%). Complications in the retroperitoneal group were seen in 2 patients. One patient had a postoperative urinary leak that resolved spontaneously. Another patient had develo...
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Transperitoneal and Retroperitoneal Laparoscopic Heminephrectomy—What Approach for Which Patient?
Journal of Urology, 2006Co-Authors: Miguel Castellan, Rafael Gosalbez, A.j. Carmack, J.c. Prieto, Marcos Perez-brayfield, Andrew LabbieAbstract:Purpose: We report our experience with laparoscopic Heminephrectomy using the transperitoneal and retroperitoneal approaches in 48 pediatric patients.Materials and Methods: A total of 48 laparoscopic heminephrectomies were performed in 35 girls and 13 boys 45 days to 17 years old (mean 4.08 years) between September 1998 and March 2005. The procedures consisted of 44 upper pole heminephrectomies with partial or total ureterectomies and 4 lower pole heminephroureterectomies. Surgeries were performed using a transperitoneal approach in 32 patients (67%) and a retroperitoneal approach in 16 (33%).Results: Followup ranged from 0.75 to 7.25 years (mean 3.53). In the retroperitoneal group 2 procedures required conversion, 1 to open Heminephrectomy and 1 to a transperitoneal laparoscopic approach. Complications were seen in 5 of 48 patients (10%). Complications in the retroperitoneal group were seen in 2 patients. One patient had a postoperative urinary leak that resolved spontaneously. Another patient had develo...
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Transperitoneal and retroperitoneal laparoscopic Heminephrectomy--what approach for which patient?
The Journal of urology, 2006Co-Authors: Miguel Castellan, Rafael Gosalbez, A.j. Carmack, J.c. Prieto, Marcos Perez-brayfield, Andrew LabbieAbstract:We report our experience with laparoscopic Heminephrectomy using the transperitoneal and retroperitoneal approaches in 48 pediatric patients. A total of 48 laparoscopic heminephrectomies were performed in 35 girls and 13 boys 45 days to 17 years old (mean 4.08 years) between September 1998 and March 2005. The procedures consisted of 44 upper pole heminephrectomies with partial or total ureterectomies and 4 lower pole heminephroureterectomies. Surgeries were performed using a transperitoneal approach in 32 patients (67%) and a retroperitoneal approach in 16 (33%). Followup ranged from 0.75 to 7.25 years (mean 3.53). In the retroperitoneal group 2 procedures required conversion, 1 to open Heminephrectomy and 1 to a transperitoneal laparoscopic approach. Complications were seen in 5 of 48 patients (10%). Complications in the retroperitoneal group were seen in 2 patients. One patient had a postoperative urinary leak that resolved spontaneously. Another patient had development of a urinoma that was treated conservatively. Complications in the transperitoneal group were seen in 3 patients. One patient required an intraoperative chest tube due to pneumothorax, 1 had recurrent urinary tract infection that required excision of a short ureteral remnant and 1, 6-month-old boy had development of postoperative hypertension. Four of the 5 complications (80%) were seen in patients younger than 1 year. Transperitoneal and retroperitoneal laparoscopic Heminephrectomy can be performed for benign disease in children with minimal morbidity, improved cosmesis and short hospital stay. Complication rate does not depend on the surgical approach, but rather on the age of the patient.
Boris Chertin - One of the best experts on this subject based on the ideXlab platform.
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Fate of the Retained Ureteral Stump After Upper Pole Heminephrectomy in Duplex Kidneys
The Journal of urology, 2002Co-Authors: Diane De Caluwé, Boris Chertin, Prem PuriAbstract:Purpose: We review the long-term outcome of retained ureteral stumps in children undergoing Heminephrectomy for nonfunctioning upper pole moieties in duplex kidneys.Materials and Methods: The medical records of 50 patients who underwent 50 upper pole heminephrectomies for a nonfunctioning upper pole moiety of a duplex kidney between January 1990 and December 2000 were reviewed retrospectively.Results: Median patient age at Heminephrectomy was 2.5 years (range 3 weeks to 16.5 years) and median followup was 6 years (range 1 to 11). Indications for Heminephrectomy in the 50 renal units were obstructive ureterocele in 25 (50%) cases, ectopic ureter in 15 (30%), obstructive megaloureter in 5 (10%) and reflux nephropathy in 5 (10%). A total of 48 (96%) of the corresponding ureters were taken down as low as possible and transfixed through the Heminephrectomy incision. Residual stump excision was required in 5 (10%) of the 50 units for recurrent urinary tract infection due to vesicoureteral reflux.Conclusions: Ou...
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Long-term outcome of the retained ureteral stump after lower pole Heminephrectomy in duplex kidneys.
European urology, 2002Co-Authors: Diane De Caluwé, Boris Chertin, Prem PuriAbstract:Abstract Objectives: Duplication of the ureter and renal pelvis is the most common upper urinary tract anomaly in childhood. The anatomical and functional divisions between upper and lower moieties of duplex kidney are extremely variable. The underlying pathological condition associated with a lower moiety is usually massive vesicoureteral reflux (VUR) to the lower collecting system and only rare obstruction. The non-functioning upper moiety is usually associated with obstructive ectopic ureter (with or without ureterocele). Most lower pole heminephrectomies are carried out for non-functioning lower moieties. In most cases, the lower defunctionalised segment of the ureter is left in situ. Complete ureterectomy is usually performed if presence of VUR into the lower end of the corresponding ureter is shown. There is little information on the long-term outcome of residual ureteral ‘stumps'. The purpose of our study was to review the long-term outcome of retained ureteral stumps in children undergoing Heminephrectomy for non-functioning lower pole moieties in duplex kidneys. Materials and Methods: The medical records of 19 patients who underwent 20 lower pole heminephrectomies for a non-functioning lower pole moiety of a duplex kidney between January 1990 and December 2000 were reviewed retrospectively. Median age at Heminephrectomy was 4.5 years (range: 1 month to 12 years). Indications for Heminephrectomy in the 20 renal units was reflux nephropathy in 16 (80%) and obstructive nephropathy in 4 (20%). All corresponding ureters were taken down as low as possible and transfixed through the Heminephrectomy incision. Median follow-up was 8.5 years (range: 1–11 years). Results: Eight (40%) showed VUR into the stump after lower pole Heminephrectomy. Two of these underwent subureteral endoscopic correction of VUR with polytetrafluoroethylene paste and resection of the stump was carried out in remaining two patients for recurrent urinary tract infections (UTI). Remaining four of the eight patients demonstrated spontaneous resolution of VUR during follow-up. Conclusions: Our data suggest that the vast majority of patients with residual ureteral stumps after lower pole Heminephrectomy do not require stump resection at long-term follow-up.
Miguel Castellan - One of the best experts on this subject based on the ideXlab platform.
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transperitoneal and retroperitoneal laparoscopic Heminephrectomy what approach for which patient
The Journal of Urology, 2006Co-Authors: Miguel Castellan, Rafael Gosalbez, A.j. Carmack, J.c. Prieto, Marcos Perezbrayfield, Andrew LabbieAbstract:Purpose: We report our experience with laparoscopic Heminephrectomy using the transperitoneal and retroperitoneal approaches in 48 pediatric patients.Materials and Methods: A total of 48 laparoscopic heminephrectomies were performed in 35 girls and 13 boys 45 days to 17 years old (mean 4.08 years) between September 1998 and March 2005. The procedures consisted of 44 upper pole heminephrectomies with partial or total ureterectomies and 4 lower pole heminephroureterectomies. Surgeries were performed using a transperitoneal approach in 32 patients (67%) and a retroperitoneal approach in 16 (33%).Results: Followup ranged from 0.75 to 7.25 years (mean 3.53). In the retroperitoneal group 2 procedures required conversion, 1 to open Heminephrectomy and 1 to a transperitoneal laparoscopic approach. Complications were seen in 5 of 48 patients (10%). Complications in the retroperitoneal group were seen in 2 patients. One patient had a postoperative urinary leak that resolved spontaneously. Another patient had develo...
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Transperitoneal and Retroperitoneal Laparoscopic Heminephrectomy—What Approach for Which Patient?
Journal of Urology, 2006Co-Authors: Miguel Castellan, Rafael Gosalbez, A.j. Carmack, J.c. Prieto, Marcos Perez-brayfield, Andrew LabbieAbstract:Purpose: We report our experience with laparoscopic Heminephrectomy using the transperitoneal and retroperitoneal approaches in 48 pediatric patients.Materials and Methods: A total of 48 laparoscopic heminephrectomies were performed in 35 girls and 13 boys 45 days to 17 years old (mean 4.08 years) between September 1998 and March 2005. The procedures consisted of 44 upper pole heminephrectomies with partial or total ureterectomies and 4 lower pole heminephroureterectomies. Surgeries were performed using a transperitoneal approach in 32 patients (67%) and a retroperitoneal approach in 16 (33%).Results: Followup ranged from 0.75 to 7.25 years (mean 3.53). In the retroperitoneal group 2 procedures required conversion, 1 to open Heminephrectomy and 1 to a transperitoneal laparoscopic approach. Complications were seen in 5 of 48 patients (10%). Complications in the retroperitoneal group were seen in 2 patients. One patient had a postoperative urinary leak that resolved spontaneously. Another patient had develo...
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Transperitoneal and retroperitoneal laparoscopic Heminephrectomy--what approach for which patient?
The Journal of urology, 2006Co-Authors: Miguel Castellan, Rafael Gosalbez, A.j. Carmack, J.c. Prieto, Marcos Perez-brayfield, Andrew LabbieAbstract:We report our experience with laparoscopic Heminephrectomy using the transperitoneal and retroperitoneal approaches in 48 pediatric patients. A total of 48 laparoscopic heminephrectomies were performed in 35 girls and 13 boys 45 days to 17 years old (mean 4.08 years) between September 1998 and March 2005. The procedures consisted of 44 upper pole heminephrectomies with partial or total ureterectomies and 4 lower pole heminephroureterectomies. Surgeries were performed using a transperitoneal approach in 32 patients (67%) and a retroperitoneal approach in 16 (33%). Followup ranged from 0.75 to 7.25 years (mean 3.53). In the retroperitoneal group 2 procedures required conversion, 1 to open Heminephrectomy and 1 to a transperitoneal laparoscopic approach. Complications were seen in 5 of 48 patients (10%). Complications in the retroperitoneal group were seen in 2 patients. One patient had a postoperative urinary leak that resolved spontaneously. Another patient had development of a urinoma that was treated conservatively. Complications in the transperitoneal group were seen in 3 patients. One patient required an intraoperative chest tube due to pneumothorax, 1 had recurrent urinary tract infection that required excision of a short ureteral remnant and 1, 6-month-old boy had development of postoperative hypertension. Four of the 5 complications (80%) were seen in patients younger than 1 year. Transperitoneal and retroperitoneal laparoscopic Heminephrectomy can be performed for benign disease in children with minimal morbidity, improved cosmesis and short hospital stay. Complication rate does not depend on the surgical approach, but rather on the age of the patient.