title: Laparoscopic pyeloplasty in children: long-term outcome.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Urology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India. ansarimsa@hotmail.com
authors.forename: Mohd S
authors.initials: MS
authors.lastname: Ansari
authors.forename: Anil
authors.initials: A
authors.lastname: Mandhani
authors.forename: Partipal
authors.initials: P
authors.lastname: Singh
authors.forename: Aneesh
authors.initials: A
authors.lastname: Srivastava
authors.forename: Anant
authors.initials: A
authors.lastname: Kumar
authors.forename: Rakesh
authors.initials: R
authors.lastname: Kapoor
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007682:Kidney Pelvis / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000601:surgery*