title: Comparison of Laparoscopic Approaches for Dismembered Pyeloplasty in Children With Ureteropelvic Junction Obstruction: Critical Analysis of 11-Year Experiences in a Single Surgeon.
abstract: OBJECTIVE
  The choice of different laparoscopic approaches of laparoscopic pyeloplasty (LP) in children remains controversial. We present a comparison of different approaches of LP in children and a critical analysis of 11-year experiences in a single surgeon.
  
  
  METHODS
  There were 1750 patients (1889 sides) who underwent LP between 2003 and 2014 reviewed. The diagnosis and outcomes of ureteropelvic junction obstruction (UPJO) were reviewed based on clinical and imaging data. Retroperitoneal laparoscopic pyeloplasty (RPLP) were performed in 451 cases (RPLP group), conventional transperitoneal laparoscopic pyeloplasty (CTLP) were performed in 311 cases (CTLP group), transumbilical single-site laparoscopic pyeloplasty (TSLP) were performed in 322 cases (TSLP group), and transumbilical multiport laparoscopic pyeloplasty (TMLP) were performed in 805 cases (TMLP group). We assessed preoperative clinical data and outcomes, and analyzed the transition experience. Data are expressed as medians for continuous variables.
  
  
  RESULTS
  The start of oral feeding, hospital stay, and the operative time of RPLP group were 1.10 ± 0.10 days, 5.22 ± 1.32 days, and 138.2 ± 20.1 minutes, respectively. Compared with the other 3 groups, the start of oral feeding was the soonest, hospital stay was the shortest, and the operative time was the longest in the RPLP group (P < .01 or .05). The cosmetic result of the TMLP group was 7.07 ± 1.20 scores, and there are significant differences in cosmetic results between the TMLP group and the other 3 groups (P < .05).
  
  
  CONCLUSIONS
  Although the 4 laparoscopic approaches for LP in children with UPJO are safe and efficient procedures with equivalent success rates, we recommend RPLP or TMLP as a treatment option for children with UPJO.
authors.affiliation: Department of Pediatric Urology, Bayi Children's Hospital, PLA Army General Hospital (formerly The Military General Hospital of Beijing PLA), Beijing, China.
authors.forename: Dehong
authors.initials: D
authors.lastname: Liu
authors.affiliation: Department of Pediatric Urology, Bayi Children's Hospital, PLA Army General Hospital (formerly The Military General Hospital of Beijing PLA), Beijing, China. Electronic address: huixia99999@163.com.
authors.forename: Huixia
authors.initials: H
authors.lastname: Zhou
authors.affiliation: Department of Pediatric Urology, Bayi Children's Hospital, PLA Army General Hospital (formerly The Military General Hospital of Beijing PLA), Beijing, China.
authors.forename: Lifei
authors.initials: L
authors.lastname: Ma
authors.affiliation: Department of Pediatric Urology, Bayi Children's Hospital, PLA Army General Hospital (formerly The Military General Hospital of Beijing PLA), Beijing, China.
authors.forename: Xiaoguang
authors.initials: X
authors.lastname: Zhou
authors.affiliation: Department of Pediatric Urology, Bayi Children's Hospital, PLA Army General Hospital (formerly The Military General Hospital of Beijing PLA), Beijing, China.
authors.forename: Hualin
authors.initials: H
authors.lastname: Cao
authors.affiliation: Department of Pediatric Urology, Bayi Children's Hospital, PLA Army General Hospital (formerly The Military General Hospital of Beijing PLA), Beijing, China.
authors.forename: Tian
authors.initials: T
authors.lastname: Tao
authors.affiliation: Department of Pediatric Urology, Bayi Children's Hospital, PLA Army General Hospital (formerly The Military General Hospital of Beijing PLA), Beijing, China.
authors.forename: Xiaolong
authors.initials: X
authors.lastname: Luo
authors.affiliation: Department of Pediatric Urology, Bayi Children's Hospital, PLA Army General Hospital (formerly The Military General Hospital of Beijing PLA), Beijing, China.
authors.forename: Shaojun
authors.initials: S
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D007223:Infant; D007682:Kidney Pelvis / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D061646:Operative Time; D019651:Plastic Surgery Procedures / Q000379:methods*; D012187:Retroperitoneal Space; D012189:Retrospective Studies; D066231:Surgeons / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery*; D014517:Ureteral Obstruction / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods