title: Laparoscopic dismembered pyeloplasty for ureteropelvic junction obstruction in children.
abstract: OBJECTIVE
  To present our initial experience with laparoscopic pyeloplasty and to evaluate the safety and short-term outcome of this technique in children.
  
  
  METHODS
  Thirteen kidney units in twelve children underwent laparoscopic dismembered pyeloplasty for the management of ureteropelvic junction obstruction (UPJO) at our institution between 2005 and 2008. Patient age at surgery was 18-177 months (mean 89.8 months). There were six boys and six girls. Ten had unilateral UPJO with a normal contralateral kidney, one had bilateral UPJO and one had UPJO of a solitary kidney. We used 3- and 5-mm instruments for grasping, blunt dissection, incising and suturing to facilitate safe and precise surgery. The outcome was measured by the operative time and resolution of obstruction and symptoms.
  
  
  RESULTS
  Median operative time was 275 min (range 154-420). There was a slight relationship between age and operative time. No major perioperative complications occurred in any cases. Median renal pelvic anterior-posterior diameter at ultrasonography significantly decreased from 8.6 cm (range 3.8-22.0) preoperatively to 3.9 cm (1.0-8.9) postoperatively (P < 0.05). The median pre- and postoperative split renal function on diuretic renography in unilateral cases was 37.3% (range 29.7-46.4) and 39.5% (27.8-48.0), respectively. Overall, successful resolution of UPJO was observed in 12 of 13 kidneys (92.3%).
  
  
  CONCLUSIONS
  Laparoscopic pyeloplasty represents a safe and effective option in the surgical treatment of children with UPJO.
authors.affiliation: Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kojima
authors.forename: Shoichi
authors.initials: S
authors.lastname: Sasaki
authors.forename: Kentaro
authors.initials: K
authors.lastname: Mizuno
authors.forename: Keiichi
authors.initials: K
authors.lastname: Tozawa
authors.forename: Yutaro
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kohri
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007682:Kidney Pelvis / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D011183:Postoperative Complications; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery*; D014517:Ureteral Obstruction / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*