Nigerian Postgraduate Medical Journal (Jan 2014)
Laparoscopic pyeloplasty for Children with pelvic ure- teric junction obstruction: An institutional experience
Abstract
Aims and Objectives: To give a report of 36 consecutive children who underwent laparoscopic Anderson-Hynes dismembered pyeloplasty by a single lead sur- geon. Patients and Methods: The diagnosis of pelviureteric junction obstruction was firmly established in all patients based on history, clinical examination, renal sonography and scintigraphy. Transperitoneal laparoscopic Anderson-Hynes pyeloplasty was performed in all the patients. Age at surgery, duration of opera- tion, complications and outcome were documented. Children were followed up for symptoms, and diuretics renography was repeated at 3 months. Results: A total of 36 children 5 months to 11 years (25 boys and 11girls) under- went laparoscopic Anderson- Hynes pyeloplasty over a 4- year period. Mean age at surgery was 41 months (range 7 to 144). Seventeen (47%) cases were antenatally diagnosed. The mean operating time was 247min. No patient required blood transfusion, and there were no intra-operative complications. The mean postop- erative hospital stay was 5.8days. There were 7 postoperative complications including urinary tract infection (n=6) and shoulder pain (n=1). The symptoms improved in 32(89%) children. There were 3 conversions, 2 due to non rotated kidney and one due to double right moiety. One child had failed pyeloplasty with deteriorating renal function. He had a redo open pyeloplasty. The mean split renal function before surgery and at follow up diuretic scan was 36.2 vs 42.1, P=0.001. The mean follow up period was 30months. Conclusion: Laparoscopic Anderson-Hynes pyeloplasty is safe and effective in the management of children with pelvi-ureteric junction obstruction.
