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Minimally Invasive Correction of Vesicoureteral Reflux: Experience at One institution
Christina Kim, MD, Katherine Herbst, MSc, John Makari, MD, Renee Silvis, none, Shikha Singh, MD, Fernando Ferrer, MD.
Connecticut Children's Medical Center, Hartford, CT, USA.
Introduction
Minimally invasive correction of vesicoureteral reflux (VUR) has gained popularity in the past two decades. The benefits of minimally invasive surgery (MIS) have been well established. Obviously, we do not want these benefits to be offset by lower success and increased morbidity.
We performed a retrospective review of all MIS to correct VUR at our institution.
Materials and Methods
After obtaining IRB approval, we reviewed all Deflux and robotic ureteral reimplantation surgery performed between October 2007 and May 2010. We reviewed postoperative VCUG results. Success was defined as complete resolution of VUR postoperatively. We assessed for any associated complications and length of hospital stay.
Results
A total of 153 Deflux and 17 robotic reimplantations were reviewed. A total of 262 ureters were treated. Follow up was available in 162 patients (235 ureters). Mean age at surgery was78.9 months for Deflux and 74.7 months for robotic reimplantation. Mean length of stay was 1.29 days for the robotic cases. There were no intraoperative or postoperative complications noted. Complete resolution was seen in 90.9% of robotic reimplantation and 81.9% of Deflux patients.
Conclusions
MIS continues to be an attractive option for treating VUR. When compared to existing literature on open correction of VUR, the less invasive techniques do correlate with lower success rates. Continued analysis of outcomes will help parents decide which surgical approach is best for them.
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