الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 77 |  |  |
| | | from | 77 | | |
Abstract
Introduction: Vesico-ureteric reflux (VUR) is one of the main causes of hydroureter in infants and children. As treatment modalities and protocols evolved over time, ureteral reimplantation is now considered the mainstay management modality in VUR (specially in children having persistent high-grade reflux associated with recurrent febrile UTI , and/ or renal scarring).
Introducing minimally invasive modalities in pediatric urology has evolved rapidly over the last two decades. As minimally invasive armamentarium continue to improve, laparoscopy and robotic modalities have now become a significant alternative to open surgery in many pathologies; including but not limited to pyeloplasty, orchipexy, lower urinary tract reconstruction, and ureteral reimplantation.
Aim of the work: The study assesses the efficacy, surgical outcomes and safety of trans-peritoneal laparoscopic unilateral ureteral re-implantation (LEVUR) compared to the robotic assisted laparoscopic ureteric reimplantation (RALUR) in children (younger than 18 years old) diagnosed with unilateral primary vesicoureteral reflux (VUR).
Patients and methods: This is a retrospective study that recruited patients younger than 18 years old and underwent unilateral RALUR in Pediatric Urology department at Riley Children’s Hospital in Indiana, USA (group A) and Unilateral LEVUR in Pediatric Urology Department at Alexandria University Hospital (group B) from the period of January 1st, 2014 till December 31st, 2018. Records were retrieved from both centers database, and thorough assessment of admission notes, radiological notes, operative records, post-operative records, and follow up records was done. The primary outcome was the clinical and radiological success following reimplantation. The correlation between the overall complications and various variables was the secondary outcome.
Results: A higher rate of female patients were treated in group A compared to group B patients (77.3% versus 75.0 respectively). The median age in group A patients was 6.47 years (IQR 5.40-7.51) compared to 4.40 years (IQR 3.30-5.57) in group B patients.
The median operative time was 142.0 minutes (IQR 129.0-168.0) in group A, which is significantly longer compared to median operative time in group B; 92.50 minutes IQR 81.50-114.5) (p value<0.001).