Laparoscopic transperitoneal pyeloplasty in children from age of 3 years: our clinical outcomes compared with open surgery.
OBJECTIVE
To report clinical outcomes for laparoscopic pyeloplasty (LP) in children compared with open pyeloplasty (OP) and literature findings.


METHODS
In a prospective study, the outcomes of 57 consecutive transperitoneal LP in children from the age of 3 years were analyzed and compared with a matched historic control group of OP and with series of LP in the literature. Successful result was defined as resolution of symptoms, no conversion or re-operation, improved hydronephrosis, and/or improved renographic drainage.


RESULTS
Mean operative time was 177 (SD 50.5)min in the LP group and 108 (SD 25.6)min in the OP group (p < 0.001). Mean hospital stay was 1.2 (SD 0.46) days in the LP and 6.7 (SD 1.2) days in the OP group. Improvement in renographic drainage was observed more often after LP than after OP (98% vs 83%; p = 0.010). A successful result was reported in 56 (98%) LP and 54 (95%) OP (p = 0.298) patients. Our LP series demonstrates a high success rate compared to literature data.


CONCLUSIONS
Our LP has a similar success rate and more often improved renographic drainage in comparison to OP. Furthermore, our LP demonstrates a shorter hospital stay and favorable outcomes compared to the literature. We thus regard LP as standard treatment for repair of ureteropelvic junction obstruction in children from the age of 3 years.
Department of Pediatric Urology, Sophia Children's Hospital, Erasmus MC Rotterdam, PO Box 2060, 3000 CB Rotterdam, The Netherlands. f.vandertoorn.1@erasmusmc.nl
Fred
F
van der Toorn
Joop
J
van den Hoek
Katja P
KP
Wolffenbuttel
Jeroen R
JR
Scheepe
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000601:surgery*; D007682:Kidney Pelvis / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D061646:Operative Time; D010537:Peritoneum / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis; D011446:Prospective Studies; D012086:Reoperation; D013536:Suture Techniques; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery; D014517:Ureteral Obstruction / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*