Outcome analysis of Cohen’s cross trigonal ureteric reimplantation in paediatric age group

Introduction: Cohen’s cross trigonal ureteric reimplantation is the gold standard for surgical management of vesicoureteric reflux (VUR) in children with high success rate. The objective of this study was to evaluate and assess the outcome of open Cohen’s procedure in children with VUR.  Methods...

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Main Authors: Suman Bikram Adhikari, Ramanandan Prasad Chaudhary, Tul Maya Gurung, Sanjay Sah, Shovita Rana
Format: Article
Language:English
Published: Society of Surgeons of Nepal 2022-12-01
Series:Journal of Society of Surgeons of Nepal
Subjects:
Online Access:https://www.nepjol.info/index.php/JSSN/article/view/50808
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author Suman Bikram Adhikari
Ramanandan Prasad Chaudhary
Tul Maya Gurung
Sanjay Sah
Shovita Rana
author_facet Suman Bikram Adhikari
Ramanandan Prasad Chaudhary
Tul Maya Gurung
Sanjay Sah
Shovita Rana
author_sort Suman Bikram Adhikari
collection DOAJ
description Introduction: Cohen’s cross trigonal ureteric reimplantation is the gold standard for surgical management of vesicoureteric reflux (VUR) in children with high success rate. The objective of this study was to evaluate and assess the outcome of open Cohen’s procedure in children with VUR.  Methods: A retrospective review of all patients with VUR who underwent Cohen’s procedure between March 2010 and February 2020 was done. The following were recorded for each patient: age, sex, grade of reflux, operative time, outcome and complications.  Results: The series consisted of 40 patients (25 girls and 15 boys) who underwent Cohen’s procedure with a mean age of 32 months (6 months to 8 years). Bilateral repairs were performed in 16 patients (40%) in the same setting and unilateral repair in 24 patients (60%). Twenty-two patients (55%) had grade IV VUR, 13 patients (32.5%) had grade V VUR and 05 patients (12.5%) had grade III VUR. Mean operative time for bilateral repairs was 249.4(200-290) minutes and 158.3(130-180) minutes for unilateral repair respectively. The mean length of hospital stay was 10.55 (7-15) days. Major complications included two persistent VURs, and one case of bladder hematoma. Postoperative ultrasound abdomen in all patients and micturating cystourethrogram in few patients was obtained, in which 38 patients (95%) had normal study. Conclusion: Cohen’s uretric reimplantation is a standard procedure in paediatric VUR. For better outcome, patient selection and refinement of operative technique should be pursued.
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spelling doaj.art-43d63072e2ee47df8019d59303a160672023-01-17T09:56:52ZengSociety of Surgeons of NepalJournal of Society of Surgeons of Nepal1815-39842392-47722022-12-01252Outcome analysis of Cohen’s cross trigonal ureteric reimplantation in paediatric age groupSuman Bikram AdhikariRamanandan Prasad ChaudharyTul Maya GurungSanjay SahShovita Rana Introduction: Cohen’s cross trigonal ureteric reimplantation is the gold standard for surgical management of vesicoureteric reflux (VUR) in children with high success rate. The objective of this study was to evaluate and assess the outcome of open Cohen’s procedure in children with VUR.  Methods: A retrospective review of all patients with VUR who underwent Cohen’s procedure between March 2010 and February 2020 was done. The following were recorded for each patient: age, sex, grade of reflux, operative time, outcome and complications.  Results: The series consisted of 40 patients (25 girls and 15 boys) who underwent Cohen’s procedure with a mean age of 32 months (6 months to 8 years). Bilateral repairs were performed in 16 patients (40%) in the same setting and unilateral repair in 24 patients (60%). Twenty-two patients (55%) had grade IV VUR, 13 patients (32.5%) had grade V VUR and 05 patients (12.5%) had grade III VUR. Mean operative time for bilateral repairs was 249.4(200-290) minutes and 158.3(130-180) minutes for unilateral repair respectively. The mean length of hospital stay was 10.55 (7-15) days. Major complications included two persistent VURs, and one case of bladder hematoma. Postoperative ultrasound abdomen in all patients and micturating cystourethrogram in few patients was obtained, in which 38 patients (95%) had normal study. Conclusion: Cohen’s uretric reimplantation is a standard procedure in paediatric VUR. For better outcome, patient selection and refinement of operative technique should be pursued. https://www.nepjol.info/index.php/JSSN/article/view/50808Cohen’s procedureUreteric reimplantationVesicoureteric reflux
spellingShingle Suman Bikram Adhikari
Ramanandan Prasad Chaudhary
Tul Maya Gurung
Sanjay Sah
Shovita Rana
Outcome analysis of Cohen’s cross trigonal ureteric reimplantation in paediatric age group
Journal of Society of Surgeons of Nepal
Cohen’s procedure
Ureteric reimplantation
Vesicoureteric reflux
title Outcome analysis of Cohen’s cross trigonal ureteric reimplantation in paediatric age group
title_full Outcome analysis of Cohen’s cross trigonal ureteric reimplantation in paediatric age group
title_fullStr Outcome analysis of Cohen’s cross trigonal ureteric reimplantation in paediatric age group
title_full_unstemmed Outcome analysis of Cohen’s cross trigonal ureteric reimplantation in paediatric age group
title_short Outcome analysis of Cohen’s cross trigonal ureteric reimplantation in paediatric age group
title_sort outcome analysis of cohen s cross trigonal ureteric reimplantation in paediatric age group
topic Cohen’s procedure
Ureteric reimplantation
Vesicoureteric reflux
url https://www.nepjol.info/index.php/JSSN/article/view/50808
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AT tulmayagurung outcomeanalysisofcohenscrosstrigonaluretericreimplantationinpaediatricagegroup
AT sanjaysah outcomeanalysisofcohenscrosstrigonaluretericreimplantationinpaediatricagegroup
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