Comparison of transumbilical multiport and standard laparoscopic pyeloplasty in children: Mid-term results at a single center.
OBJECTIVE
To compare the efficacy of transumbilical multiport (TMLP) and standard laparoscopic pyeloplasty (SLP) for the treatment of congenital ureteropelvic junction obstruction in children.


METHODS
Forty-eight patients were included in this matched-pair study. The TMLP applied three transumbilical incisions for one 5-mm and two 3-mm ports, whereas SLP was undertaken with traditional three-port technique. The demographic, perioperative, and follow-up data were retrospectively compared between TMLP (n=24) and SLP (n=24) groups.


RESULTS
Two groups were matched according to patient's age, gender, laterality, weight, and surgical indication. TMLP and SLP were successfully performed in all patients, without conversion to open procedure. There was no significant difference between both groups in intraoperative blood loss, time to oral feeding, time to normal activities, pain scores, or complication rates. Longer mean operative time (125.4±21.6 vs. 112.2±25.2 min; P=0.012) and better patient satisfaction (30.4±4.5 vs. 24.6±3.4; P=0.026) were noted in TMLP group than those in SLP group. Mid-term follow-up indicated no significant difference in postoperative alleviation of hydronephrosis or improvement of renal function.


CONCLUSIONS
TMLP is a feasible and efficient procedure for the management of congenital ureteropelvic junction obstruction in children, with comparative outcome and better cosmetic results than SLP.
Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, Hubei Province, PR China.
Hong
H
Mei
Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, Hubei Province, PR China.
Xiang
X
Zhao
Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, Hubei Province, PR China.
Dan
D
Li
Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, Hubei Province, PR China.
Erhu
E
Fang
Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, Hubei Province, PR China.
Xiaojing
X
Wang
Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, Hubei Province, PR China.
Huajie
H
Song
Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, Hubei Province, PR China.
Jiarui
J
Pu
Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, Hubei Province, PR China; Clinical Center of Human Genomic Research, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, Hubei Province, PR China.
Liduan
L
Zheng
Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, Hubei Province, PR China; Clinical Center of Human Genomic Research, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, Hubei Province, PR China. Electronic address: qs_tong@hotmail.com.
Qiangsong
Q
Tong
D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000209:etiology / Q000601:surgery; D007223:Infant; D007682:Kidney Pelvis / Q000002:abnormalities / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D061646:Operative Time; D017060:Patient Satisfaction; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014513:Ureter / Q000002:abnormalities / Q000601:surgery*; D014517:Ureteral Obstruction / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*
Children; Congenital ureteropelvic junction obstruction; Laparoscopic pyeloplasty; Transumbilical multiport