title: Retroperitoneal laparoscopic dismembered pyeloplasty with a novel technique of JJ stenting in children.
abstract: OBJECTIVE
  • To report our experience with retroperitoneal laparoscopic dismembered pyeloplasty for pelvi-ureteric junction (PUJ) obstruction in children.
  
  
  METHODS
  • Between March 2007 and December 2009, 38 children with PUJ obstruction (mean age 8.3 years, range 3-14) underwent retroperitoneal laparoscopic dismembered pyeloplasty. • A ureteric catheter was inserted into the mid-ureter cystoscopically. During pyeloplasty, the proximal end of the ureteric catheter was extracorporeally sutured to the distal end of the JJ stent with silk. • The ureteric catheter was then pulled down and the stent was pulled antegrade into the ureter and bladder.
  
  
  RESULTS
  • The approach was retroperitoneal in all patients except one who required open conversion. The overall mean operative time was 162 min (range 145-210 min) and this appeared to decrease with experience. Mean hospital stay was 4 days (range 3-7 days). • Mean follow-up was 20.2 months (range 6-32 months). Satisfactory drainage with decreased hydronephrosis was documented in all patients on ultrasonography and intravenous urography.
  
  
  CONCLUSIONS
  • Our study shows that retroperitoneal laparoscopic dismembered pyeloplasty is a feasible and effective alternative to open pyeloplasty with a relatively minimal complication rate in children 3 years of age and older, but it should be undertaken by experienced laparoscopic surgeons.
authors.affiliation: Department of Urology, Hubei Provincial Corps Hospital, Chinese People's Armed Police Forces, Wuhan, HuBei, China.
authors.forename: Jianhua
authors.initials: J
authors.lastname: Yu
authors.forename: Zhonghua
authors.initials: Z
authors.lastname: Wu
authors.forename: Youming
authors.initials: Y
authors.lastname: Xu
authors.forename: Zhuo
authors.initials: Z
authors.lastname: Li
authors.forename: Jiansong
authors.initials: J
authors.lastname: Wang
authors.forename: Fan
authors.initials: F
authors.lastname: Qi
authors.forename: Xiang
authors.initials: X
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D002675:Child, Preschool; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D012187:Retroperitoneal Space; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000503:physiopathology / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000295:instrumentation / Q000379:methods*