One-trocar-assisted pyeloplasty in children: an 8-year single institution experience.
BACKGROUND
Ureteropelvic junction obstruction (UPJO) is the most common pediatric obstructive uropathy. We report our 8-year experience with the use of a retroperitoneal laparoscopic-assisted pyeloplasty (one-trocar-assisted pyeloplasty [OTAP]).


METHODS
This is a retrospective analysis of 88 patients treated in 8 years. Surgery was performed on the basis of standard indications and it consisted of 88 OTAP (the ureteropelvic junction is identified through a retroperitoneoscopic inspection and it is exteriorized to perform a traditional dismembered pyeloplasty). Operative time, hospital stay, complication, success of the technique, and aesthetical results are analyzed.


RESULTS
In the 8-year period we performed 88 OTAP. Mean age was 19 months. Prenatal diagnosis was the most common presentation (n = 73), followed by occasional identification (n = 8), and symptomatic (n = 7). Mean operating time was 139 minutes (range 60-225 minutes). Conversion was required in seven cases. The success rate was 87.5% (reduction of the severity of hydronephrosis on ultrasound) and 100% among symptomatic patients (symptoms resolution). Aesthetical results were excellent.


CONCLUSIONS
OTAP is safe, feasible, and efficacious. Operative times are similar or even shorter than those of other minimally invasive techniques and complication rate agrees with the findings of literature. OTAP can be considered a reasonable alternative.
Department of Pediatric Surgery, University of Bologna Sant'Orsola-Malpighi Hospital, Bologna, Italy.
Mario
M
Lima
Department of Pediatric Surgery, University of Bologna Sant'Orsola-Malpighi Hospital, Bologna, Italy.
Giovanni
G
Ruggeri
Department of Pediatric Surgery, University of Bologna Sant'Orsola-Malpighi Hospital, Bologna, Italy.
Paolo
P
Messina
Department of Pediatric Surgery, University of Bologna Sant'Orsola-Malpighi Hospital, Bologna, Italy.
Stefano
S
Tursini
Department of Pediatric Surgery, University of Bologna Sant'Orsola-Malpighi Hospital, Bologna, Italy.
Francesca
F
Destro
Department of Pediatric Surgery, University of Bologna Sant'Orsola-Malpighi Hospital, Bologna, Italy.
Mirella
M
Mogiatti
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000517:prevention & control; D005260:Female; D006801:Humans; D007682:Kidney Pelvis / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D007902:Length of Stay; D008297:Male; D061646:Operative Time; D012187:Retroperitoneal Space; D012189:Retrospective Studies; D014517:Ureteral Obstruction / Q000601:surgery*