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Objective <p>To compare the long-term efficacy and safety of Cohen versus modified Glenn-Anderson pneumovesicoscopic ureteral reimplantation and to define the learning curves for both procedures.</p> Methods <p>A single-center retrospective cohort study (2007–2021) included 75 children with primary obstructive megaureter (POM) (Cohen: <i>n</i> = 27; modified Glenn-Anderson: <i>n</i> = 48). Primary outcomes were reoperation rates and ureteral recovery (diameter &lt;&#xa0;7&#xa0;mm) during long-term follow-up. Cumulative sum (CUSUM) analysis was used to model learning curves based on operative time. A meta-analysis of 10 studies (529 patients) established a benchmark success rate.</p> Results <p>After a mean follow-up of 99.0 (Cohen) and 75.7 (modified Glenn-Anderson) months, reoperation-free rates were 92.6% and 95.8%, respectively (<i>P</i> &gt; 0.05), with no significant differences in complication rates or functional improvement. CUSUM analysis indicated a learning phase of 22 cases for Cohen and 19 cases for modified Glenn-Anderson, with operative time decreasing by over 30% upon mastery. The meta-analysis yielded a pooled reoperation-free rate of 99.4%.</p> Conclusions <p>Both techniques demonstrate comparable long-term safety and efficacy for POM. The modified Glenn-Anderson technique offers a valid alternative that preserves the ureter’s anatomical course. Achieving procedural proficiency requires approximately 20 cases. While global success rates are high, long-term follow-up is crucial for detecting late complications.</p>

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Long-term efficacy and learning curves of Cohen and modified Glenn-Anderson pneumovesicoscopic ureteral reimplantation for primary obstructive megaureter: a retrospective cohort study with meta-analysis

  • 期刊论文

  • 发表日期：

    2026年3月25日

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  • Haotian Pan,
  • Runwu Wang,
  • Mengnan Jiang,
  • Shan Li,
  • Xiangpan Kong,
  • Junhong Liu,
  • Xing Liu,
  • Tao Lin,
  • Guanghui Wei,
  • Dawei He

摘要

Objective

To compare the long-term efficacy and safety of Cohen versus modified Glenn-Anderson pneumovesicoscopic ureteral reimplantation and to define the learning curves for both procedures.

Methods

A single-center retrospective cohort study (2007–2021) included 75 children with primary obstructive megaureter (POM) (Cohen: n = 27; modified Glenn-Anderson: n = 48). Primary outcomes were reoperation rates and ureteral recovery (diameter < 7 mm) during long-term follow-up. Cumulative sum (CUSUM) analysis was used to model learning curves based on operative time. A meta-analysis of 10 studies (529 patients) established a benchmark success rate.

Results

After a mean follow-up of 99.0 (Cohen) and 75.7 (modified Glenn-Anderson) months, reoperation-free rates were 92.6% and 95.8%, respectively (P > 0.05), with no significant differences in complication rates or functional improvement. CUSUM analysis indicated a learning phase of 22 cases for Cohen and 19 cases for modified Glenn-Anderson, with operative time decreasing by over 30% upon mastery. The meta-analysis yielded a pooled reoperation-free rate of 99.4%.

Conclusions

Both techniques demonstrate comparable long-term safety and efficacy for POM. The modified Glenn-Anderson technique offers a valid alternative that preserves the ureter’s anatomical course. Achieving procedural proficiency requires approximately 20 cases. While global success rates are high, long-term follow-up is crucial for detecting late complications.