title: Early experience of using transumbilical multi-stab laparoscopic pyeloplasty for infants younger than 3 months.
abstract: OBJECTIVE
  Minimally invasive surgery is increasingly being adopted in pediatric urology practice. The aim of this study is to investigate the feasibility and the safety of transumbilical multi-stab laparoscopic pyeloplasty (TMLP) as a treatment for infants younger than 3 months with severe hydronephrosis.
  
  
  METHODS
  We retrospectively reviewed 63 infants younger than 3 months with severe hydronephrosis who underwent TMLP from June 2010 to March 2013. The operative indications included: 1) prenatal diagnosis of hydronephrosis with anteroposterior renal pelvic diameter greater than 3 cm and Society of Fetal Urology (SFU) Grade 4 hydronephrosis; 2) ipsilateral differential renal function being less than 40%. Patients were followed up with physical examinations, ultrasound and radionuclide scans.
  
  
  RESULTS
  The operations were successfully performed in all 63 patients. There was no conversion, no requirement of additional trocar placement and no intraoperative complication. The median age was 54 (47-87) days. The median operative time was 75 (53-118) minutes. The patients were followed up for 12 (6-36) months. The anastomoses were proved to be patent and the renal parenchymal thickness increased. The renal pelvic anteroposterior diameters were reduced and the renal functions were improved (p < 0.01). In addition, the scars were barely noticeable.
  
  
  CONCLUSIONS
  TMLP for infants younger than 3 months with severe hydronephrosis is feasible, safe and minimally invasive. The cosmetic results are excellent.
authors.affiliation: Department of Urology, Bayi Children's Hospital Affiliated to Beijing Military Region General Hospital, Beijing, People's Republic of China. Electronic address: huixia99999@163.com.
authors.forename: Huixia
authors.initials: H
authors.lastname: Zhou
authors.affiliation: Department of Urology, Bayi Children's Hospital Affiliated to Beijing Military Region General Hospital, Beijing, People's Republic of China; Medical School, Nankai University, Tianjin, People's Republic of China.
authors.forename: Xin
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Urology, Bayi Children's Hospital Affiliated to Beijing Military Region General Hospital, Beijing, People's Republic of China.
authors.forename: Huawei
authors.initials: H
authors.lastname: Xie
authors.affiliation: Department of Urology, Bayi Children's Hospital Affiliated to Beijing Military Region General Hospital, Beijing, People's Republic of China.
authors.forename: Lifei
authors.initials: L
authors.lastname: Ma
authors.affiliation: Department of Urology, Bayi Children's Hospital Affiliated to Beijing Military Region General Hospital, Beijing, People's Republic of China.
authors.forename: Xiaoguang
authors.initials: X
authors.lastname: Zhou
authors.affiliation: Department of Urology, Bayi Children's Hospital Affiliated to Beijing Military Region General Hospital, Beijing, People's Republic of China.
authors.forename: Tian
authors.initials: T
authors.lastname: Tao
authors.affiliation: Department of Urology, Bayi Children's Hospital Affiliated to Beijing Military Region General Hospital, Beijing, People's Republic of China.
authors.forename: Sichao
authors.initials: S
authors.lastname: Ma
authors.affiliation: Department of Pediatrics and Surgery, Southern Medical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia. Electronic address: girdoc@qq.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Cheng
mesh_terms: D000367:Age Factors; D002921:Cicatrix / Q000473:pathology / Q000517:prevention & control; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D007223:Infant; D007682:Kidney Pelvis / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D061646:Operative Time; D012189:Retrospective Studies; D016896:Treatment Outcome; D014472:Umbilicus / Q000601:surgery*
keywords: Infants; Laparoscopic; Pyeloplasty; Severe hydronephrosis; Transumbilical