WOFAPS 2025 8th World Congress of Pediatric Surgery

Guangjie Chen, huazhang Liu, Fan Yang, Linfeng Zhu, Dongyan Zhao, Yijun Zhao

Zhejiang University

Objective: To evaluate the efficacy of robot-assisted end-side ureteroureterostomy combined with Lich-Gregoir ureteral reimplantation in the treatment of children with duplicated renal anomalies.

Methods: Clinical data of patients with duplicated collecting systems who underwent robot-assisted end-side ureteroureterostomy coupled with Lich-Gregoir ureteral reimplantation from May 2019 to May 2023 were retrospectively analysed.All children presented with lesions in both ipsilateral upper and lower ureters,and the contralateral ureter was normal. Operative time, postoperative stay, pre and post operative renal pelvic anteroposterior diameter (APD) and ureteral diameter, complications were recorded.

Results: A total of 12 patients underwent the surgery.Clinical presentations included urinary tract infections (9), urinary incontinence (2), and abdominal pain (1).Pathological types included ureterocele(7 cases, 3cases with vesicoureteral reflux)

,ectopic ureter (5 cases, 2cases with vesicoureteral reflux) in the upper pole system.Ureterostenosis (4 cases) and vesicoureteral reflux(8 cases) in the lower pole system.The average surgical time was 221.83±41.64 minutes, and the average hospital stay was 7.7±3.0 days. There were statistically significant differences in pre- and postoperative APD and ureteral diameter in upper pole system (22.92±9.07 min vs. 7.33±5.03 mm, 11.08±3.15 vs. 5.83±2.41 mm) and pre- and postoperative APD and ureteral diameter in lower pole system (14.00±6.25 mm vs. 5.25±3.02 mm, 7.75±2.26 mm vs. 4.75±1.36 mm). One patient suffered UTI, which resolved after conservative anti-inflammatory treatment.

Conclusion:Robot-assisted ureteroureterostomy coupled with Lich-Gregoir ureteral reimplantation is a safe and effective approach for children with duplicated collecting systems.