Feasibility, safety and effectiveness of laparoscopic transperitoneal pyeloplasty in children: Ain Shams University early experience

Abstract

Abstract Background/purpose Laparoscopic pyeloplasty (LP) is now widely recognized as a minimally invasive alternative for the surgical repair of ureteropelvic junction obstruction (UPJO) in paediatrics. In this work, we aim to evaluate the feasibility, safety and effectiveness of LP in our early experience. Patients and methods Between April 2019 and April 2020, patients presented with indication for surgical repair of UPJO were offered laparoscopic transperitoneal Anderson-Hynes pyeloplasty. Demographic data, preoperative investigations, operative data and intra- or postoperative complications, as well as short and mid-term follow-ups were recorded. Results During the specified period, 13 patients underwent LP (8 girls and 5 boys) with a median age of 12 months (range from 5 to 150 months). There was no conversion to open approach with operative time ranging from 120 to 240 min (mean = 175 ± 34 min). No intra- or postoperative complications were encountered. One to 2 years postoperative follow-up was performed (median = 18 months) in 11 patients. One patient discontinued follow-up after 1 month and another after 6 months. Follow-up PAUS showed a reduction in the anteroposterior diameter of the renal pelvis in all cases. Postoperative diuretic renal scans (DTPA renography) were done for three patients with a persistent anteroposterior diameter of the renal pelvis greater than 20 mm which showed improvement in the washout. All patients had a good cosmetic outcome. Conclusion In our early experience in LP, we found the procedure a safe, feasible and effective technique in managing UPJO in children and infants with good cosmetic outcome. Level of evidence This is a case series study (level IV evidence).

Keywords

• Laparoscopic pyeloplasty
• Ureteropelvic junction obstruction
• Anderson-Hynes pyeloplasty