title: Hybrid laparoendoscopic single-site (LESS) pyeloplasty: Initial experience in children.
abstract: OBJECTIVE
  Mini-invasive surgery is still evolving to get better surgical conditions for patients with ureteropelvic junction obstruction. We used technical modifications (hybrid pyeloplasty) that simplify surgical steps of laparoendoscopic single-site pyeloplasty in children. Our aim was to compare hybrid pyeloplasty to laparoendoscopic single-site pyeloplasty and to open pyeloplasty.
  
  
  METHODS
  We retrospectively reviewed records of patients with ureteropelvic junction obstruction aged<14years undergoing pyeloplasty at our institute from January 2011 to December 2015. Demographic data, laterality, operative time, length of hospital stay, drainage tubes, and postoperative complications were recorded. Surgical outcomes were evaluated based on renal sonography and Lasix diuretic renography.
  
  
  RESULTS
  Among 38 patients, 17 underwent open pyeloplasty (group I), 10 had laparoendoscopic single-site pyeloplasty (group II) and 11 had hybrid pyeloplasty (group III). The mean age at the time of operation was 55 months. The operative time in group III was significantly shorter than that in group I and group II (P<0.001). The shortest median hospital stay was noted in the group III. The mean follow-up period was 26 months (range: 6-52 months).
  
  
  CONCLUSIONS
  The hybrid pyeloplasty using LESS combine the successful outcomes of open surgery and advantages of minimally invasive surgery. It offers small incision surgery, good working space, short operation time, secure anastomosis and good cosmetic results.
  
  
  METHODS
  5.
authors.affiliation: Department of pediatric surgery, Hedi Chaker Hospital, 3029 Sfax, Tunisia.
authors.forename: M
authors.initials: M
authors.lastname: Ben Dhaou
authors.affiliation: Department of pediatric surgery, Hedi Chaker Hospital, 3029 Sfax, Tunisia. Electronic address: zouarimohamed.1982@yahoo.fr.
authors.forename: M
authors.initials: M
authors.lastname: Zouari
authors.affiliation: Department of pediatric surgery, Hedi Chaker Hospital, 3029 Sfax, Tunisia.
authors.forename: S
authors.initials: S
authors.lastname: Ammar
authors.affiliation: Department of pediatric surgery, Hedi Chaker Hospital, 3029 Sfax, Tunisia.
authors.forename: H
authors.initials: H
authors.lastname: Zitouni
authors.affiliation: Department of pediatric surgery, Hedi Chaker Hospital, 3029 Sfax, Tunisia.
authors.forename: M
authors.initials: M
authors.lastname: Jallouli
authors.affiliation: Department of pediatric surgery, Hedi Chaker Hospital, 3029 Sfax, Tunisia.
authors.forename: R
authors.initials: R
authors.lastname: Mhiri
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007682:Kidney Pelvis / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D012189:Retrospective Studies; D014513:Ureter / Q000601:surgery*; D014517:Ureteral Obstruction / Q000601:surgery*; D018666:Ureteroscopy
keywords: Children; Cœlio-chirurgie mono-trocart; Enfant; Laparoscopie; Laparoscopy; Pyeloplasty; Pyéloplastie; Single-site surgery