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Laparoscopic pyeloplasty in children: Long‐term outcome
Author(s) -
Ansari Mohd S,
Mandhani Anil,
Singh Partipal,
Srivastava Aneesh,
Kumar Anant,
Kapoor Rakesh
Publication year - 2008
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2008.02139.x
Subject(s) - medicine , pyeloplasty , surgery , blood loss , laparoscopy , foley , hydronephrosis , urinary system
Objectives: To asses the safety and efficacy of laparoscopic pyeloplasty in pediatric patients. Methods: Data of pediatric patients under the age of 14 years, who had undergone laparoscopic pyeloplasty from January 2000 to December 2005, were prospectively analyzed. The various parameters recorded were: operative time, blood loss, need for analgesics, intra/postoperative complications, hospital stay and postoperative outcome. Success was defined as either symptomatic improvement and/or better drainage on postoperative isotope renography Results: There were 53 patients with a mean age of 9.12 years (1–14 years) and a male to female ratio of 4.3:1. Dismembered pyeloplasty was done in 41 patients and Foley Y‐V plasty in 12 patients via a transperitoneal approach using 3 ports in 50 children or 4 ports in 3 children. Mean operative time was 181 min (78–369); mean blood loss was 118.01 mL (50–250) with a mean hospital stay of 5.05 days (2–11). Conversion to open surgery was required in 4 (7.54%) patients. Follow‐up renograms were available in 49 patients, which showed improvement in drainage in 44 patients and an obstructed pattern in five; of these, two patients had significant deterioration in split function. Two patients among the obstructed group underwent redo pyeloplasty by open technique while the other three elected for a conservative approach. Thus at a mean follow up of 24.58 months (4–45) the overall success rate was 89.75%. Conclusions: Laparoscopic pyeloplasty is a safe and effective, minimally invasive procedure in pediatric patients with a good intermediate term success rate and minimal morbidity.