MP55-10 REVISITING THE VASCULAR HITCH PROCEDURE FOR CROSSING VESSELS IN PAEDIATRIC PATIENTS—a LONGITUDINAL INSTITUTIONAL EXPERIENCE OVER 15 YEARS

You have accessJournal of UrologyPediatrics IV (MP55)1 May 2024MP55-10 REVISITING THE VASCULAR HITCH PROCEDURE FOR CROSSING VESSELS IN PAEDIATRIC PATIENTS—a LONGITUDINAL INSTITUTIONAL EXPERIENCE OVER 15 YEARS Franziska Juliane Richter, Joana Dos Santos, Catalina Sánchez, Camila Moreno Bencardino, Daniel T. Keefe, Rodrigo Romao, Jin K. Kim, Michael E. Chua, Mandy Rickard, and Armando J. Lorenzo Franziska Juliane RichterFranziska Juliane Richter , Joana Dos SantosJoana Dos Santos , Catalina SánchezCatalina Sánchez , Camila Moreno BencardinoCamila Moreno Bencardino , Daniel T. KeefeDaniel T. Keefe , Rodrigo RomaoRodrigo Romao , Jin K. KimJin K. Kim , Michael E. ChuaMichael E. Chua , Mandy RickardMandy Rickard , and Armando J. LorenzoArmando J. Lorenzo View All Author Informationhttps://doi.org/10.1097/01.JU.0001008616.01808.0f.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Congenital ureteropelvic junction obstruction (UPJO) may occur due to intrinsic narrowing or extrinsic compression secondary to a crossing vessel and is usually managed with a dismembered pyeloplasty. However, in the case of crossing vessels, vascular hitch procedures may be a feasible alternative. Herein we describe the long-term outcome of the vascular hitch procedure, a somewhat controversial approach to address UPJO secondary to crossing vessels. METHODS: A 15-year retrospective chart review of patients with UPJO at our institution was performed. Assessed variables included basic demographics, procedure time, length of stay, surgical approach, stents, and complications. Redo procedures (n=2) and cases with unavailable data (n=10) were excluded. RESULTS: A total of 49 patients underwent VH (30 male, 19 female) on the left (n=32) or right side (n=17) with a mean postoperative follow-up duration of 12.9 +9.2 months. Median age at surgery was 115.0 months (IQR29, 222). The majority were performed laparoscopically (43/49). No case required stent insertion. The procedure time was 130 minutes (IQR80, 276). Length of stay (LOS) was <10 hours in the majority (61.2%) of patients (IQR4, 133). Preoperative renal AP-Diameter was 26.0 mm (IQR5,80), which decreased to 10.0 mm (IQR0,44) at last follow-up, with a mean reduction of 15.6 +18.7 mm without any re-interventions. One patient complained of mild flank pain which was managed conservatively. No major postoperative complications were observed. CONCLUSIONS: Our institutional data demonstrates the efficacy and safety of paediatric VR in cases of aberrant vessels with short LOS, high success rate and short OR times. As we continue to accrue data with longer follow-up, our experience suggests that there are clear advantages of this approach compared to other procedures. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e920 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Franziska Juliane Richter More articles by this author Joana Dos Santos More articles by this author Catalina Sánchez More articles by this author Camila Moreno Bencardino More articles by this author Daniel T. Keefe More articles by this author Rodrigo Romao More articles by this author Jin K. Kim More articles by this author Michael E. Chua More articles by this author Mandy Rickard More articles by this author Armando J. Lorenzo More articles by this author Expand All Advertisement PDF downloadLoading ...