title: Simplified open approach to surgical treatment of ureteropelvic junction obstruction in young children and infants.
abstract: OBJECTIVE
  Indications for laparoscopic pyeloplasty for ureteropelvic junction obstruction are steadily growing but there is still a group of young children in whom open surgery continues to be the procedure most performed by pediatric urologists. We report our results in young children and infants with dismembered pyeloplasty done through a small flank incision on an outpatient basis or during a short hospital stay.
  
  
  METHODS
  Between April 2001 and July 2009, 45 patients with a median age of 11.2 months (range 1 to 50), of whom 72.9% were male, with confirmed ureteropelvic junction obstruction underwent classic Anderson-Hynes dismembered pyeloplasty thorough a 2.5 to 3.5 cm flank incision. Obstruction was on the left side in 51.2% of the patients. Pyeloureteral anastomosis was performed with a continuous 7-zero polydioxanone suture over a 7Fr multiperforated pyelostomy self-designed catheter in 89% of the patients. A Double-J® catheter was used in only 4 patients with other associated conditions. The stent was removed in the office 7 to 12 days after surgery.
  
  
  RESULTS
  Mean operative time was 92 minutes (range 60 to 150). Median hospital stay was 11.5 hours (range 6 to 35) in the whole group but it decreased to 9.4 hours in the last 22 cases. There was no reoperation due to recurrent ureteropelvic junction obstruction. Mean postoperative followup was 47.5 months.
  
  
  CONCLUSIONS
  Ureteropelvic junction obstruction surgery in small children can be done safely through a small incision with a short hospital stay without morbidity and with good cosmesis. We believe that open pyeloplasty will continue to be the best standard treatment for ureteropelvic junction obstruction surgery in small children until miniaturization and better laparoscopic instruments allow us to reproduce these results.
authors.affiliation: Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Ruiz
authors.forename: Ricardo
authors.initials: R
authors.lastname: Soria
authors.forename: Edurne
authors.initials: E
authors.lastname: Ormaechea
authors.forename: Mauricio Marcelo Urquizo
authors.initials: MM
authors.lastname: Lino
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: Moldes
authors.forename: Francisco Ignacio
authors.initials: FI
authors.lastname: de Badiola
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007682:Kidney Pelvis / Q000601:surgery*; D008297:Male; D014517:Ureteral Obstruction / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods