title: Laparoscopic pyeloplasty for children with pelvic ureteric junction obstruction: an institutional experience.
abstract: OBJECTIVE
  To give a report of 36 consecutive children who underwent laparoscopic Anderson-Hynes dismembered pyeloplasty by a single lead surgeon.
  
  
  METHODS
  The diagnosis of pelviureteric junction obstruction was firmly established in all patients based on history, clinical examination, renal sonography and scintigraphy. Transperitoneal laparoscopic Anderson-Hynes pyeloplasty was performed in all the patients. Age at surgery, duration of operation, complications and outcome were documented. Children were followed up for symptoms, and diuretics renography was repeated at 3 months.
  
  
  RESULTS
  A total of 36 children 5 months to 11 years (25 boys and 11 girls) under- went laparoscopic Anderson- Hynes pyeloplasty over a 4- year period. Mean age at surgery was 41 months (range 7 to 144). Seventeen (47%) cases were antenatally diagnosed. The mean operating time was 247 min. No patient required blood transfusion, and there were no intra-operative complications. The mean postoperative hospital stay was 5.8 days. There were 7 postoperative complications including urinary tract infection (n=6) and shoulder pain (n=1). The symptoms improved in 32(89%) children. There were 3 conversions, 2 due to non rotated kidney and one due to double right moiety. One child had failed pyeloplasty with deteriorating renal function. He had a redo open pyeloplasty. The mean split renal function before surgery and at follow up diuretic scan was 36.2 vs 42.1, P=0.001. The mean follow up period was 30 months.
  
  
  CONCLUSIONS
  Laparoscopic Anderson-Hynes pyeloplasty is safe and effective in the management of children with pelvi-ureteric junction obstruction.
authors.affiliation: Division of Paediatric Surgery, Department of surgery, University of Ilorin Teaching Hospital, Ilorin, Nigeria.
authors.forename: Abdulrasheed A
authors.initials: AA
authors.lastname: Nasir
authors.forename: Mohan K
authors.initials: MK
authors.lastname: Abraham
authors.forename: Bindu
authors.initials: B
authors.lastname: Sudarshan
authors.forename: Ramakrishnan
authors.initials: R
authors.lastname: Puzhankara
authors.forename: Prashant
authors.initials: P
authors.lastname: Kedari
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007682:Kidney Pelvis / Q000601:surgery; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D012189:Retrospective Studies; D014517:Ureteral Obstruction / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*