title: Surgical outcomes of laparoscopic dismembered pyeloplasty in children with giant hydronephrosis secondary to ureteropelvic junction obstruction.
abstract: OBJECTIVE
  Studies of surgical outcomes after reconstructive surgery for giant hydronephrosis (GH) secondary to ureteropelvic junction (UPJ) obstruction are limited. Over the past two decades, laparoscopic pyeloplasty has gradually replaced open repair in children in several centres. The objective of this study was to assess surgical outcomes of laparoscopic pyeloplasty in children with GH.
  
  
  METHODS
  Children with unilateral primary UPJ obstruction and GH were prospectively included and underwent laparoscopic pyeloplasty. Postoperative ultrasonography was repeated at 3 and 12 months to assess renal parenchymal thickness, and similarly a renogram was repeated to assess improvement in differential renal function.
  
  
  RESULTS
  During the study period 2005-2009, 53 children underwent laparoscopic dismembered pyeloplasty for UPJ obstruction. Of these, 8 children had GH caused by UPJ obstruction. The postoperative differential renal function improved in all of them. The postoperative improvement in renal parenchymal thickness at the end of 12 months was comparable to that of the non-GH group.
  
  
  CONCLUSIONS
  At 12 months, surgical outcomes after laparoscopic pyeloplasty for GH were satisfactory. Relief of obstruction allows adequate and comparable nephron sparing.
authors.affiliation: Department of Urology, KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital & MRC, KLE University's JN Medical College, Belgaum 590010, India. director@kleskf.org
authors.forename: R B
authors.initials: RB
authors.lastname: Nerli
authors.forename: M N
authors.initials: MN
authors.lastname: Reddy
authors.forename: M B
authors.initials: MB
authors.lastname: Hiremath
authors.forename: D
authors.initials: D
authors.lastname: Shishir
authors.forename: S M
authors.initials: SM
authors.lastname: Patil
authors.forename: A
authors.initials: A
authors.lastname: Guntaka
mesh_terms: D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003251:Constriction, Pathologic / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006869:Hydronephrosis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D007682:Kidney Pelvis / Q000473:pathology* / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D014517:Ureteral Obstruction / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D014567:Urography / Q000379:methods; D013520:Urologic Surgical Procedures / Q000379:methods*