Ureteral reconstruction for retroperitoneal tumors in children Journal Article


Authors: Rutigliano, D. N.; Georges, A.; Wolden, S. L.; Kayton, M. L.; Meyers, P.; La Quaglia, M. P.
Article Title: Ureteral reconstruction for retroperitoneal tumors in children
Abstract: Purpose: Removal of solid tumors of the pelvis and abdominal cavity may require resection of an involved ureteral segment. Ureteral stricture can also be a result of intense therapy. We present our experience with urinary reconstruction in this situation. Methods: A retrospective review of pediatric oncology patients with solid abdominal/pelvic tumors who underwent a ureteral reconstructive procedure was done. Institutional review board wavier was obtained for the review. Patient data were collected on diagnosis, procedures performed, renal function, and follow-up. Results: Thirteen patients were identified: 8 male and 5 female. The mean age at surgery was 10.1 years. The most common reason for surgery was en bloc tumor resection (n = 8) followed by ureteral strictures (n = 3). The Boari flap, Leadbetter-Politano reimplantation, and psoas hitch were the most common procedures preformed. Follow-up studies included measurements of serum urea nitrogen/creatinine levels as well as renal scans to assess functional status; 2 patients had elevated serum urea nitrogen/creatinine levels at follow-up. The mean follow-up time was 18 months; 4 patients died-none was secondary to renal complications. There were no local tumor recurrences. Conclusions: Abdominal and pelvic tumors frequently involve the ureter, and their removal should not necessitate acceptance of poor surgical margins. Complete surgical resection of tumor including involved ureteral segments can prolong survival in patients with extensive abdominopelvic cancers. In another group of patients, ureteral strictures arise secondary to therapy and reconstruction may preserve renal function. © 2007 Elsevier Inc. All rights reserved.
Keywords: adolescent; adult; child; clinical article; treatment outcome; child, preschool; cancer surgery; surgical technique; survival rate; reconstructive surgical procedures; retrospective studies; plastic surgery; solid tumor; follow up; follow-up studies; cohort studies; creatinine; creatinine blood level; urea nitrogen blood level; age factors; retrospective study; information processing; childhood cancer; risk assessment; postoperative complication; kidney function; neuroblastoma; tumor recurrence; ureter stricture; pelvis tumor; data analysis; surgical mortality; urologic surgical procedures; neoplasm invasiveness; retroperitoneal tumor; retroperitoneal neoplasms; rhabdomyosarcoma; sex factors; sarcoma, ewing's; serum; functional status; nitrogen; surgical patient; urea; kidney scintiscanning; boari flap; psoas hitch; ureteral injury; ureteral reconstruction; psoas abscess; reimplantation; urea blood level; ureter surgery; ureteral diseases
Journal Title: Journal of Pediatric Surgery
Volume: 42
Issue: 2
ISSN: 0022-3468
Publisher: W.B. Saunders Co-Elsevier Inc.  
Date Published: 2007-02-01
Start Page: 355
End Page: 358
Language: English
DOI: 10.1016/j.jpedsurg.2006.10.007
PUBMED: 17270548
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 2" - "Export Date: 17 November 2011" - "CODEN: JPDSA" - "Source: Scopus"
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MSK Authors
  1. Suzanne L Wolden
    502 Wolden
  2. Mark Lawrence Kayton
    19 Kayton
  3. Paul Meyers
    294 Meyers