title: Unstented laparoscopic pyeloplasty in young children (1-5 years old): a comparison with a repair using double-J stent or transanastomotic externalized stent.
abstract: OBJECTIVE
  To evaluate feasibility of unstented laparoscopic pyeloplasty in young children to prevent pyelonephritis and second anaesthesia.
  
  
  METHODS
  During 2006-2013, 70 children (1-5 years old) underwent laparoscopic pyeloplasty for high grade hydronephrosis. Unstented repair was indicated in 34 children (GroupL1), double-J stent was placed in 21 patients (Group L2) and uretero-pyelostomy stent (Cook) in 15 patients (Group L3). Stenting was preferred in large thin-walled pelvis, thin ureter, kidney malrotation, and unfavourable course of crossing vessels. The outcome was compared with age-matched group of 52 children who had open surgery during 1996-2006 (Groups O1, O3).
  
  
  RESULTS
  Operation times were significantly shorter in Groups L1 and L2 than in Group L3; the times were shorter in open repairs. Three patients with crossing vessels from Group L1 had urine leakage and one had obstruction (11.4%). In Group L2, one patient had obstruction, one incorrect placement of the stent, and one girl had serious pyelonephritis (14.3%). In Group L3, displacement of uretero-pyelostomy occurred in one patient (6.7%). There is no statistical difference between laparoscopic groups and between laparoscopic and open groups.
  
  
  CONCLUSIONS
  Unstented laparoscopic pyeloplasty is a safe procedure in selected young children with favourable anatomical conditions preventing additional anaesthesia and stent-related complications.
authors: Department of Urology, General Teaching Hospital in Praha and Charles University 1st Faculty of Medicine, Praha, Czech Republic. Electronic address: radim.kocvara@lf1.cuni.cz.
authors: Radim
authors: R
authors: Kočvara
authors: Department of Urology, General Teaching Hospital in Praha and Charles University 1st Faculty of Medicine, Praha, Czech Republic. Electronic address: josef.sedlacek@vfn.cz.
authors: Josef
authors: J
authors: Sedláček
authors: Department of Urology, General Teaching Hospital in Praha and Charles University 1st Faculty of Medicine, Praha, Czech Republic. Electronic address: marcel.drlik@seznam.cz.
authors: Marcel
authors: M
authors: Drlík
authors: Department of Urology, General Teaching Hospital in Praha and Charles University 1st Faculty of Medicine, Praha, Czech Republic. Electronic address: ZdenekDite@seznam.cz.
authors: Zdeněk
authors: Z
authors: Dítě
authors: Institute of Biophysics, Charles University 1st Faculty of Medicine and General Teaching Hospital in Praha, Praha, Czech Republic. Electronic address: jaromir.belacek@lf1.cuni.cz.
authors: Jaromír
authors: J
authors: Běláček
authors: Department of Urology, General Teaching Hospital in Praha and Charles University 1st Faculty of Medicine, Praha, Czech Republic. Electronic address: vojta.mail@seznam.cz.
authors: Vojtěch
authors: V
authors: Fiala
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000601:surgery*; D007223:Infant; D007682:Kidney Pelvis / Q000601:surgery; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D011474:Prosthesis Design; D011704:Pyelonephritis / Q000517:prevention & control; D015607:Stents; D014517:Ureteral Obstruction / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*
keywords: Double-J stent in children; Laparoscopic pyeloplasty in children; Paediatric pyeloplasty; Unstented laparoscopic pyeloplasty; Ureteropelvic junction obstruction