Comparison of laparoscopic-assisted versus open dismembered pyeloplasty for ureteropelvic junction obstruction in infants: intermediate results.
OBJECTIVE
To compare the results of laparoscopic-assisted dismembered pyeloplasty (LADP) with open dismembered pyeloplasty in infants. LADP is an innovative minimally invasive technique to mobilize and exteriorize the ureteropelvic junction for Anderson-Hynes dismembered pyeloplasty.


METHODS
A total of 23 infants (mean 7.3 months, range 2-11) underwent LADP via the retroperitoneal approach. An additional 21 children (mean 8.2 months, range 3-12) underwent similar procedures via open surgery. We retrospectively compared the operative time, hospital stay, postoperative complications, and follow-up.


RESULTS
Patient demographic data were similar between the 2 groups. Mean operative time was significantly shorter in the open surgery than the LADP group (95.4 vs 102.6 minutes, P <.05). The mean incision length (2 vs 5 cm), recovery of intestinal function (24.3 vs 48.2 hours), and postoperative hospital stay (2.5 vs 5 days) were better in the LADP group than in the open group (P <.01). No intraoperative complications occurred in either group. Mean follow-up was 19 (range 6-36) and 24 (range 12-48) months in the LADP and open surgery groups, respectively. The incidence of postoperative complications (3 of 23, 13.0% vs 3 of 21, 14.3%; P = .33) and success rates (22 of 23, 95.7% vs 20 of 21, 95.2%; P = .51) were equivalent in the 2 groups.


CONCLUSIONS
Shorter hospital stay, early recovery, and better cosmetic results may be the advantages of LADP over open surgery in small infants, which should be confirmed by a prospective and randomized study.
Tong
Qiangsong
Q
Department of Pediatric Surgery, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, People's Republic of China. qs_tong@hotmail.com
Zheng
Liduan
L
Tang
Shaotao
S
Zeng
Fuqing
F
Du
Zhiyong
Z
Mei
Hong
H
Wu
Zehua
Z
Pu
Jiarui
J
Ruan
Qinglan
Q
D005260:Female; D006801:Humans; D007223:Infant; D007682:Kidney Pelvis / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D009392:Nephrectomy / Q000379:methods*; D012189:Retrospective Studies; D014517:Ureteral Obstruction / Q000601:surgery*