Faculty Collaboration Database

Robot-Assisted Laparoscopic Excision of Ureteral and Ureteropelvic Junction Fibroepithelial Polyps in Children. J Endourol 2016 Aug;30(8):896-900

Date

06/10/2016

Pubmed ID

27279495

DOI

10.1089/end.2016.0006

Scopus ID

2-s2.0-84979998276 (requires institutional sign-in at Scopus site)   14 Citations

Abstract

INTRODUCTION: Fibroepithelial polyps of the ureter are a rare cause of asymptomatic and symptomatic upper urinary tract obstruction in children. While these lesions can often be managed endoscopically, large or multifocal polyps may preclude such an approach.

OBJECTIVE: We aim to describe our institutional experience with robot-assisted laparoscopic treatment of ureteral polyps and show that a robotic approach is an effective alternative for large or multifocal polyps.

MATERIALS AND METHODS: Four children were identified with ureteral polyps over a 5-year period and underwent transperitoneal robot-assisted laparoscopic excision. Patients presented with flank pain and/or worsening hydronephrosis. All patients were evaluated preoperatively with ultrasound and Tc99m-mercaptoacetyltriglycine (MAG3) diuretic renogram or MR urogram. Retrograde pyelography corroborated the diagnosis of ureteral polyps. We reviewed the charts of these patients and compared the specific robotic approach for each patient, length of hospitalization, surgical complications, need for additional procedures, and resolution of symptoms and hydronephrosis.

RESULTS: In one patient, more than 20 polyps were identified over a long ureteral segment and all were excised; for the remaining three patients, 1 to 2 polyps were found. Mean postoperative length of stay was 1.5 days. One patient developed a ureteral stricture requiring repeat ureteroureterostomy, and another patient required repeat retrograde pyelography for gross hematuria that occurred several months after surgery. No polyps or obstruction was observed on retrograde pyelography in these patients. Mean duration of follow-up was 29 months (9-62 months). Symptoms and degree of hydronephrosis have improved in the three patients who have been followed for at least 12 months.

CONCLUSIONS: Robot-assisted laparoscopy is a safe and feasible alternative to endoscopic treatment of fibroepithelial ureteral polyps. The robotic platform may be preferred in cases of multifocal or large ureteral polyps, or in cases in which a concomitant ureteropelvic junction narrowing may be present.

Author List

Osbun N, Ellison JS, Lendvay TS

Author

Jonathan Scott Ellison MD Associate Professor in the Urologic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Child
Child, Preschool
Humans
Hydronephrosis
Kidney
Kidney Neoplasms
Kidney Pelvis
Laparoscopy
Length of Stay
Magnetic Resonance Imaging
Male
Neoplasms, Fibroepithelial
Polyps
Postoperative Period
Radionuclide Imaging
Retrospective Studies
Robotic Surgical Procedures
Technetium Tc 99m Mertiatide
Ultrasonography
Ureter
Ureteral Neoplasms
Ureteral Obstruction
Urologic Surgical Procedures