Surgical outcomes of laparoscopic dismembered pyeloplasty in children with giant hydronephrosis secondary to ureteropelvic junction obstruction

• Published in: Journal of pediatric urology 2012-08, Vol.8 (4), p.401-404
• Main Authors: Nerli, R.B, Reddy, M.N, Hiremath, M.B, Shishir, D, Patil, S.M, Guntaka, A
• Format: Article
• Language: English
• Subjects: Child; Child, Preschool; Cohort Studies; Constriction, Pathologic - surgery; Female; Follow-Up Studies; Humans; Hydronephrosis; Hydronephrosis - diagnosis; Hydronephrosis - etiology; Hydronephrosis - surgery; Kidney Pelvis - pathology; Kidney Pelvis - surgery; Laparoscopy; Laparoscopy - methods; Male; Pediatrics; Prospective Studies; Risk Assessment; Severity of Illness Index; Time Factors; Tomography, X-Ray Computed - methods; Treatment Outcome; Ultrasonography, Doppler; Ureteral Obstruction - complications; Ureteral Obstruction - diagnosis; Ureteral Obstruction - surgery; Ureteropelvic junction obstruction; Urography - methods; Urologic Surgical Procedures - methods; Urology
• ISSN: 1477-5131; 1873-4898
• DOI: 10.1016/j.jpurol.2011.08.008

Abstract Objective Studies of surgical outcomes after reconstructive surgery for giant hydronephrosis (GH) secondary to ureteropelvic junction (UPJ) obstruction are limited. Over the past two decades, laparoscopic pyeloplasty has gradually replaced open repair in children in several centres. The objective of this study was to assess surgical outcomes of laparoscopic pyeloplasty in children with GH. Materials and Methods Children with unilateral primary UPJ obstruction and GH were prospectively included and underwent laparoscopic pyeloplasty. Postoperative ultrasonography was repeated at 3 and 12 months to assess renal parenchymal thickness, and similarly a renogram was repeated to assess improvement in differential renal function. Results During the study period 2005–2009, 53 children underwent laparoscopic dismembered pyeloplasty for UPJ obstruction. Of these, 8 children had GH caused by UPJ obstruction. The postoperative differential renal function improved in all of them. The postoperative improvement in renal parenchymal thickness at the end of 12 months was comparable to that of the non-GH group. Conclusions At 12 months, surgical outcomes after laparoscopic pyeloplasty for GH were satisfactory. Relief of obstruction allows adequate and comparable nephron sparing.