WOFAPS 2025 8th World Congress of Pediatric Surgery

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Poster - 87

Modified Shanfield ureteric reimplantation with or without ureteric tailoring in primary obstructive megaureter in a paediatric age group in lower-middle income country.

Suman Bikram Adhikari 1, Surendra Bikram Adhikari 2, Bal Mukunda Basnet 1
1 Kanti Children's Hospital, Maharajgunj, Kathmandu
2 Grande International Hospital, Kathmandu

Background: Obstructive megaureter is one of the leading cause of renal failure. If not resolve on time, surgical correction is necessary. Excision of stricture part and ureteric reimplantation is procedure of choice. Modified shanfield technique is one of the surgical procedures for ureteric reimplantation with good outcome. Those with huge megaureter, excisional tapering of distal ureter to facilitate ureteric reimplantation is mandatory. The objective of this study was to evaluate and assess the outcome of modified shanfield procedure in children with obstructive megaureter.

Methods: A retrospective review of all patients with obstructive megaureter who underwent modified shanfield ureteric reimplantation with or without ureteric tailoring between April 2022 to March 2024 was done. The following were recorded for each patient: age, sex, laterality, ureteral diameter, operative time, hospital stay, outcome and complications.

Results: This study consisted of 16 paediatric patients (6 boys and 10 girls) who underwent modified shanfield ureteric reimplantation with or without ureteric tailoring with a mean age of 47 months (12 months to 132 months). Left side repair was performed in 10 patients (62.5%). Mean operative time was 118 minutes. The mean length of hospital was 6.65 days (5- 9 days). None of the patients developed major complications including vesicoureteric reflux or stricture but three cases had febrile UTI. Follow up ultrasound and DTPA scan was obtained after 6 months postoperatively, which showed improved renal function in DTPA in 14 patients (93.4%).

Conclusions: Modified shanfield ureteric reimplantation is also an alternative procedure for ureteric reimplantation because of its easiness, quick and good outcome. Its implication in paediatric age group is also safe. For better outcome, patient selection and refinement technique should be pursued.

Keywords: Modified shanfield, Obstructed megaureter, Ureteric reimplantation, ureteric tailoring.

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