Transperitoneal laparoscopic pyeloplasty in children: does upper urinary tract anomalies affect surgical outcomes?
Int Braz J Urol
; 44(2): 370-377, 2018.
Article
in En
| MEDLINE
| ID: mdl-29368877
ABSTRACT
OBJECTIVE:
To assess the feasibility and outcomes of laparoscopic pyeloplasty in children with complex ureteropelvic junction obstruction (UPJO) and compare to children with iso-lated UPJO without associated urinary tract abnormalities. MATERIAL ANDMETHODS:
Medical records of 82 consecutive children submitted to transperitoneal laparoscopic pyeloplasty in a 12-year period were reviewed. Eleven cases were con-sidered complex, consisting of atypical anatomy including horseshoe kidneys in 6 patients, pelvic kidneys in 3 patients, and a duplex collecting system in 2 patients. Patients were di-vided into 2 groups normal anatomy (group 1) and complex cases (group 2). Demographics, perioperative data, outcomes and complications were recorded and analyzed.RESULTS:
Mean age was 8.9 years (0.5-17.9) for group 1 and 5.9 years (0.5-17.2) for group 2, p=0.08. The median operative time was 200 minutes (180-230) for group 1 and 203 minutes (120-300) for group 2, p=0.15. Major complications (Clavien ≥3) were 4 (5.6%) in group 1 and 1 (6.3%) in group 2, p=0.52. No deaths or early postoperative complications such as urinoma or urinary leakage or bleeding, occurred. The success rate for radiologic improvement and flank pain improvement was comparable between the two groups. Re-garding hydronephrosis, significant improvement was present in 62 patients (93.4%) of group 1 and 10 cases (90.9%) of group 2, p=0.99. The median hospital stay was 4 days (IQR 3-4) for group 1 and 4.8 days (IQR 3-6) for group 2, p=0.27.CONCLUSIONS:
Transperitoneal laparoscopic pyeloplasty is feasible and effective for the management of UPJO associated with renal or urinary tract anomalies.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Ureteral Obstruction
/
Urinary Tract
/
Laparoscopy
Type of study:
Observational_studies
Limits:
Adolescent
/
Child
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Child, preschool
/
Female
/
Humans
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Infant
/
Male
Language:
En
Journal:
Int Braz J Urol
Journal subject:
UROLOGIA
Year:
2018
Document type:
Article
Affiliation country:
Publication country:
BR
/
BRASIL
/
BRASILE
/
BRAZIL
/
BRESIL