Extravesical ureteral reimplantation: an outpatient procedure

The Journal of Urology
Jeffrey S Palmer

Abstract

We determined whether implementation of a critical pathway and modification of the extravesical ureteral reimplantation surgical technique to repair unilateral and bilateral vesicoureteral reflux would consistently result in same day patient hospital discharge without increased morbidity. We evaluated all children undergoing extravesical ureteral reimplantation using a modified technique that limits ureteral dissection, ureteral mobilization and detrusor dissection to as distal as possible. No surgical dissection is done in proximity to the obliterated umbilical artery, nor is the artery ligated. Patients follow a strict postoperative critical pathway, and parents receive extensive preoperative and postoperative education. The child is required to fulfill strict criteria to be discharged home. A total of 51 girls and 9 boys 0.9 to 10.5 years old (mean age 5.1) were evaluated. A total of 24 unilateral and 36 bilateral procedures were performed with and without ureteral tapering, and for single systems, duplex systems and an associated Hutch diverticulum. Overall 54 children (90%) were discharged home the same day, while only 6 (10%) went home the next day. All patients who underwent a unilateral procedure and 83% who underwent a...Continue Reading

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Citations

Dec 31, 2010·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Manuel LopezFrançois Varlet
Sep 14, 2014·Current Urology Reports·Pedro-Jose LopezRicardo Zubieta
Aug 13, 2013·Journal of Pediatric Surgery·Kwang Hyun KimSang Won Han
Dec 20, 2011·The Journal of Urology·Yong Seung LeeSang Won Han
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Mar 17, 2010·Journal of Pediatric Urology·Roberto De CastroJeffrey S Palmer
Jun 9, 2009·Journal of Perianesthesia Nursing : Official Journal of the American Society of PeriAnesthesia Nurses·Penelope Hedman, Jeffrey S Palmer
Jul 25, 2009·The Journal of Urology·Karim ChamieEric A Kurzrock
May 23, 2014·International Journal of Urology : Official Journal of the Japanese Urological Association·Yutaro HayashiYoshiyuki Kojima
Mar 31, 2016·Journal of Robotic Surgery·Julia B FinkelsteinPasquale Casale
Jun 11, 2016·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Ciro EspositoFrancois Varlet
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Jun 9, 2017·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Manuel LopezMarino Asensio

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