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Ouattara K - One of the best experts on this subject based on the ideXlab platform.
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Le mégauretère primitif de type obstructif : stratégies thérapeutiques à propos de 30 cas
Pan African Urological Surgeons’ Association. Production and hosting by Elsevier B.V., 2013Co-Authors: Diakité M.l., Coulibaly Y, Merrot T, Chaumoitre K, Alessandrini P, Berthé H.j.g., Ouattara KAbstract:RésuméObjectifPrésenter l’histoire naturelle des mégauretères primitifs de type obstructif, réévaluer notre attitude thérapeutique face aux différentes étiologies et situations du patient.Patients et méthodesNous avons revu rétrospectivement 30 enfants de 0 à 15ans entre Janvier 1996 et février 2008, suivis et traités dans le service pour mégauretère primitif de type obstructif : 16 enfants ont bénéficiés d’un diagnostic anténatal (groupe A) contre 14 enfants de diagnostic post-natal (groupe B). Ces patients ont été explorés par une échographie de l’appareil urinaire, une cystographie rétrograde et mictionnelle, une scintigraphie et une Imagerie par résonance magnétique.Résultatsl’étude a porté sur 30 enfants dont 25 garçons. L’age moyen du groupe A était de 32semaines et 3jours d’aménorrhée contre 4ans dans le groupe B. Le mégauretère était à gauche dans 48% des cas, 30% à droite et bilatéral dans 22%. Le mégauretère était obstructif non refluant dans 87% des cas, et obstructif refluant dans 13%. Le délai de suivi de nos patients de groupe A était de 4,2±1,4ans et le groupe B : 3,6±1,2ans. La dilatation urétérale rétrovésicale a régressé spontanément dans 50% des cas au cours des 2 premières années de vie. Une correction chirurgicale a été nécessaire chez 63% de nos patients.Conclusioncette étude a permis de montrer l’intérêt du diagnostic précoce et de la surveillance clinique et radiologique, proposée en 1ère intention, dans la prise en charge du mégauretère et pouvant entraîner la résolution spontanée du mégauretère.AbstractObjectivesTo present the natural history of primary obstructed Megaureters, and to reassess the therapeutic approach towards patients based on both the natural history and the etiologies of the disease.Subjects and methodsWe conducted a retrospective review of 30 children between newborn and 15 years of age who were followed and treated for primary obstructed Megaureters between January 1996 and February 2008 in the department of urology at the Point G hospital. They were divided into 2 groups based on etiology: group A included 16 children with an antenatal etiology and group B included 14 children with a post-natal etiology. The patients were evaluated by ultrasound of the urinary system, voiding cystourethrography, scintigraphy, and magnetic resonance imaging.ResultsOf the 30 children included in the study 25 were males. The mean age in group A was 32 weeks and 3 days of gestation, and 4 years in Group B. The Megaureter was located on the left side in 48% of cases, on the right side in 30%, and was bilateral in 22%. The Megaureter was obstructed and nonrefluxing in 87% of cases, obstructed and refluxing in 13%. The follow-up period was 4.2 ±1.4 years in group A and 3.6 ±1.2 years in group B. Half of the patients had a spontaneous regression of their retrovesical ureteral dilation within the first 2 years of life. A surgical procedure was required for 63% of the patients.ConclusionThis study showed the importance of early diagnosis, and clinical and radiologic surveillance as a first step in the care of Megaureters. A conservative approach can result in the spontaneous resolution of the Megaureter
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Le mégauretère primitif de type obstructif : stratégies thérapeutiques à propos de 30 cas
'African Journals Online (AJOL)', 2013Co-Authors: Ml Diakité, Coulibaly Y, Berthé Hjg, Merrot T, Chaumoitre K, Alessandrini P, Ouattara KAbstract:Objectives: To present the natural history of primary obstructed Megaureters, and to reassess the therapeutic approach towards patients based on both the natural history and the etiologies of the disease. Subjects and methods: We conducted a retrospective review of 30 children between newborn and 15 years of age who were followed and treated for primary obstructed Megaureters between January 1996 and February 2008 in the department of urology at the Point G hospital. They were divided into 2 groups based on etiology: group A included 16 children with an antenatal etiology and group B included 14 children with a post-natal etiology. The patients were evaluated by ultrasound of the urinary system, voiding cystourethrography, scintigraphy, and magnetic resonance imaging. Results: Of the 30 children included in the study 25 were males. The mean age in group A was 32 weeks and 3 days of gestation, and 4 years in Group B. The Megaureter was located on the left side in 48% of cases, on the right side in 30%, and was bilateral in 22%. The Megaureter was obstructed and nonrefluxing in 87% of cases, obstructed and refluxing in 13%. The follow-up period was 4.2 ± 1.4 years in group A and 3.6 ± 1.2 years in group B. Half of the patients had a spontaneous regression of their retrovesical ureteral dilation within the first 2 years of life. A surgical procedure was required for 63% of the patients. Conclusion: This study showed the importance of early diagnosis, and clinical and radiologic surveillance as a first step in the care of Megaureters. A conservative approach can result in the spontaneous resolution of the Megaureter.Keywords: Megaureter; Surveillance; SurgeryAfrican Journal of Urology (2013) 19, 107–11
Zhou Liqun - One of the best experts on this subject based on the ideXlab platform.
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Laparoscopic ureteral reimplantation with extracorporeal tailoring and direct nipple ureteroneocystostomy for adult obstructive Megaureter: long-term outcomes and comparison to open procedure
INTERNATIONAL UROLOGY AND NEPHROLOGY, 2017Co-Authors: Zhong Wenlong, Li Xuesong, Yao Lin, Cui Haoran, Yang Kunlin, Wang Gang, Xu Tao, Ye Xiongjun, Zhou LiqunAbstract:To evaluate the long-term outcomes of laparoscopic ureteral reimplantation with extracorporeal tailoring and direct nipple ureteroneocystostomy for adult obstructive Megaureter and compare the results with the open procedure. From January 2007 to July 2013, 22 patients underwent laparoscopic and 28 patients underwent open ureteral reimplantation for adult obstructive Megaureter. For laparoscopic group, the dilated ureter was delivered out of through a 12-mm port and the distal end was tailored and formed into an antireflux nipple extracorporeally. The ureteral nipple was intracorporeally reimplanted into the posterolateral wall of the bladder. Demographics, complications and follow-up data were analyzed and compared retrospectively between the groups. Baseline characteristics including age, gender, body mass index, affected side, age at diagnosis and follow-up time were statistically similar for the groups. All of the surgeries were performed successfully, and no major complications occurred. Comparing with the open group, the use of our novel laparoscopic procedure resulted in less estimated blood loss (50.0 vs. 71.0 ml; P = 0.001), less narcotic analgesic (3.0 vs. 18.0 mg; P = 0.01) and shorter hospital stay (5.1 vs. 7.9 days; P < 0.001). Long-term outcomes including rates of recurrent ureteral stricture (4.5 vs. 0%; P = 0.25), rates of vesicoureteral reflux (9.1 vs. 3.6%, P = 0.42) and success rates (86.4 vs. 96.9%; P = 0.45) did not significantly differ between the two groups. Laparoscopic ureteral reimplantation with extracorporeal tailoring and direct nipple ureteroneocystostomy is a safe and equally effective as the open surgery for the long-term outcomes of adult obstructive Megaureter.SCI(E)ARTICLE111973-19784
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Laparoscopic Ureteral Reimplantation With Extracorporeal Tailoring and Direct Nipple Ureteroneocystostomy for Adult Obstructed Megaureter: A Novel Technique
urology, 2013Co-Authors: He Rui, Yu Wei, Li Xuesong, Yao Lin, He Zhisong, Zhou LiqunAbstract:INTRODUCTION To describe a novel technique using extracorporeal tailoring and an inverted ureteral nipple to perform laparoscopic transperitoneal ureteral reimplantation for adult obstructed Megaureter and our initial experience with 10 patients. TECHNICAL CONSIDERATIONS Ten patients (mean age 39.2 years [range, 21-62]) with adult obstructed Megaureter underwent transperitoneal laparoscopic ureteral reimplantation by a 3- or 4-port technique. In each case, the affected ureter was freed and delivered out of the peritoneal cavity through the ipsilateral 12-mm port. The lower end of the ureter was tailored by approximately 6 cm, and the tip was folded back onto itself and secured with absorbable sutures to form a nipple. A double-J stent was placed, the entire assembly was carefully replaced into the abdomen, and the ureter was reimplanted into the posterolateral wall of the bladder. CONCLUSION Surgery was successful in all the 10 patients without the need for open conversion. At a mean follow-up of 17 months, all patients were asymptomatic, and hydronephrosis was relieved in 9 cases. Laparoscopic ureteral reimplantation with extracorporeal tailoring and direct nipple ureteroneocystostomy is an easy, safe, and effective procedure for adult obstructed Megaureter. (C) 2013 Elsevier Inc.Urology & NephrologySCI(E)PubMed1ARTICLE51171-11748
Liqun Zhou - One of the best experts on this subject based on the ideXlab platform.
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laparoscopic ureteral reimplantation with extracorporeal tailoring and direct nipple ureteroneocystostomy for adult obstructive Megaureter long term outcomes and comparison to open procedure
International Urology and Nephrology, 2017Co-Authors: Wenlong Zhong, Lin Yao, Haoran Cui, Kunlin Yang, Gang Wang, Liqun ZhouAbstract:To evaluate the long-term outcomes of laparoscopic ureteral reimplantation with extracorporeal tailoring and direct nipple ureteroneocystostomy for adult obstructive Megaureter and compare the results with the open procedure. From January 2007 to July 2013, 22 patients underwent laparoscopic and 28 patients underwent open ureteral reimplantation for adult obstructive Megaureter. For laparoscopic group, the dilated ureter was delivered out of through a 12-mm port and the distal end was tailored and formed into an antireflux nipple extracorporeally. The ureteral nipple was intracorporeally reimplanted into the posterolateral wall of the bladder. Demographics, complications and follow-up data were analyzed and compared retrospectively between the groups. Baseline characteristics including age, gender, body mass index, affected side, age at diagnosis and follow-up time were statistically similar for the groups. All of the surgeries were performed successfully, and no major complications occurred. Comparing with the open group, the use of our novel laparoscopic procedure resulted in less estimated blood loss (50.0 vs. 71.0 ml; P = 0.001), less narcotic analgesic (3.0 vs. 18.0 mg; P = 0.01) and shorter hospital stay (5.1 vs. 7.9 days; P < 0.001). Long-term outcomes including rates of recurrent ureteral stricture (4.5 vs. 0%; P = 0.25), rates of vesicoureteral reflux (9.1 vs. 3.6%, P = 0.42) and success rates (86.4 vs. 96.9%; P = 0.45) did not significantly differ between the two groups. Laparoscopic ureteral reimplantation with extracorporeal tailoring and direct nipple ureteroneocystostomy is a safe and equally effective as the open surgery for the long-term outcomes of adult obstructive Megaureter.
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laparoscopic ureteral reimplantation with extracorporeal tailoring and direct nipple ureteroneocystostomy for adult obstructed Megaureter a novel technique
Urology, 2013Co-Authors: Lin Yao, Liqun ZhouAbstract:Introduction To describe a novel technique using extracorporeal tailoring and an inverted ureteral nipple to perform laparoscopic transperitoneal ureteral reimplantation for adult obstructed Megaureter and our initial experience with 10 patients. Technical Considerations Ten patients (mean age 39.2 years [range, 21-62]) with adult obstructed Megaureter underwent transperitoneal laparoscopic ureteral reimplantation by a 3- or 4-port technique. In each case, the affected ureter was freed and delivered out of the peritoneal cavity through the ipsilateral 12-mm port. The lower end of the ureter was tailored by approximately 6 cm, and the tip was folded back onto itself and secured with absorbable sutures to form a nipple. A double-J stent was placed, the entire assembly was carefully replaced into the abdomen, and the ureter was reimplanted into the posterolateral wall of the bladder. Conclusion Surgery was successful in all the 10 patients without the need for open conversion. At a mean follow-up of 17 months, all patients were asymptomatic, and hydronephrosis was relieved in 9 cases. Laparoscopic ureteral reimplantation with extracorporeal tailoring and direct nipple ureteroneocystostomy is an easy, safe, and effective procedure for adult obstructed Megaureter.
Lin Yao - One of the best experts on this subject based on the ideXlab platform.
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laparoscopic ureteral reimplantation with extracorporeal tailoring and direct nipple ureteroneocystostomy for adult obstructive Megaureter long term outcomes and comparison to open procedure
International Urology and Nephrology, 2017Co-Authors: Wenlong Zhong, Lin Yao, Haoran Cui, Kunlin Yang, Gang Wang, Liqun ZhouAbstract:To evaluate the long-term outcomes of laparoscopic ureteral reimplantation with extracorporeal tailoring and direct nipple ureteroneocystostomy for adult obstructive Megaureter and compare the results with the open procedure. From January 2007 to July 2013, 22 patients underwent laparoscopic and 28 patients underwent open ureteral reimplantation for adult obstructive Megaureter. For laparoscopic group, the dilated ureter was delivered out of through a 12-mm port and the distal end was tailored and formed into an antireflux nipple extracorporeally. The ureteral nipple was intracorporeally reimplanted into the posterolateral wall of the bladder. Demographics, complications and follow-up data were analyzed and compared retrospectively between the groups. Baseline characteristics including age, gender, body mass index, affected side, age at diagnosis and follow-up time were statistically similar for the groups. All of the surgeries were performed successfully, and no major complications occurred. Comparing with the open group, the use of our novel laparoscopic procedure resulted in less estimated blood loss (50.0 vs. 71.0 ml; P = 0.001), less narcotic analgesic (3.0 vs. 18.0 mg; P = 0.01) and shorter hospital stay (5.1 vs. 7.9 days; P < 0.001). Long-term outcomes including rates of recurrent ureteral stricture (4.5 vs. 0%; P = 0.25), rates of vesicoureteral reflux (9.1 vs. 3.6%, P = 0.42) and success rates (86.4 vs. 96.9%; P = 0.45) did not significantly differ between the two groups. Laparoscopic ureteral reimplantation with extracorporeal tailoring and direct nipple ureteroneocystostomy is a safe and equally effective as the open surgery for the long-term outcomes of adult obstructive Megaureter.
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laparoscopic ureteral reimplantation with extracorporeal tailoring and direct nipple ureteroneocystostomy for adult obstructed Megaureter a novel technique
Urology, 2013Co-Authors: Lin Yao, Liqun ZhouAbstract:Introduction To describe a novel technique using extracorporeal tailoring and an inverted ureteral nipple to perform laparoscopic transperitoneal ureteral reimplantation for adult obstructed Megaureter and our initial experience with 10 patients. Technical Considerations Ten patients (mean age 39.2 years [range, 21-62]) with adult obstructed Megaureter underwent transperitoneal laparoscopic ureteral reimplantation by a 3- or 4-port technique. In each case, the affected ureter was freed and delivered out of the peritoneal cavity through the ipsilateral 12-mm port. The lower end of the ureter was tailored by approximately 6 cm, and the tip was folded back onto itself and secured with absorbable sutures to form a nipple. A double-J stent was placed, the entire assembly was carefully replaced into the abdomen, and the ureter was reimplanted into the posterolateral wall of the bladder. Conclusion Surgery was successful in all the 10 patients without the need for open conversion. At a mean follow-up of 17 months, all patients were asymptomatic, and hydronephrosis was relieved in 9 cases. Laparoscopic ureteral reimplantation with extracorporeal tailoring and direct nipple ureteroneocystostomy is an easy, safe, and effective procedure for adult obstructed Megaureter.
Oğuz Ekmekcioğlu - One of the best experts on this subject based on the ideXlab platform.
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Primary Obstructive Megaureter with Giant Ureteral Stone: A Case Report
Hindawi Limited, 2013Co-Authors: Abdullah Demirtaş, Oğuz Ekmekcioğlu, Nurettin Şahin, Emre Can Akınsal, Atila TatlisenAbstract:A 19-year-old male patient was admitted with flank pain, which had lasted intermittently for four years. In X-ray, there was a radiopacity with a dimension of 6 × 4 cm on the left pelvic bone. Intravenous pyelography revealed a huge left Megaureter with a stone in the lower end and grade V hydronephrosis. A left ureterolithotomy, left nipple ureteroneocystostomy, and psoas hitch operation was performed. A voiding cystourethrogram taken three months after the operation showed no reflux, and in IVP there was reduced dilatation of the collecting system when compared to the ureter before the operation
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direct nipple ureteroneocystostomy in adults with primary obstructed Megaureter
The Journal of Urology, 2005Co-Authors: Atila Tatlisen, Oğuz EkmekcioğluAbstract:Purpose: We evaluated the results of direct nipple ureteroneocystostomy technique in adults with primary obstructed Megaureter. Materials and Methods: Five patients with a mean age of 32.5 years had a total of 6 primary obstructed Megaureters with complaints of flank pain. Two patients were female and 3 were male. In patient 1 disease was bilateral, in 3 it was on the right side and in 1 it was on the left side. In male patient 1 a thick walled right ureter could be directly inserted into the bladder without eversion or tapering. The left nipple was created with spatulation. In 2 cases the ureters were thin walled (2 mm or less) and the nipples were created without spatulation. In the other 2 cases the nipples were created following spatulation since the ureteral walls were thicker (2 to 3 mm). Results: Mean followup was 36 months. Flank pain complaints resolved in the postoperative period. Early postoperative Whitaker tests revealed nonobstructed renal units. At later followup visits excretory urograms and/or ultrasound showed partially resolved hydroureteronephrosis. Conclusions: Ease of application, a high success rate and no need to taper or plicate the ureter, or prepare a submucosal tunnel might be the reasons to consider the direct nipple technique for Megaureters of different etiologies.