Abstract
Objectives:To compare the therapeutic effect of retroperitoneoscopic dismembered pyeloplasty and open ureteropelvic junction plasty on the ureteropelvic junction obstruction (UPJO) in children.Methods:After the retrospective analysis of clinical data, 78 children with ureteropelvic junction stenosis treated from January, 2012 to June, 2018 were divided into two groups: OP (open pyeloplasty) group (38 cases) and LP (laparoscopic dismembered pyeloplasty) group (40 cases) according to the surgical methods. The operation time, intraoperative bleeding volume, postoperative length of stay (LOS), postoperative complication rate, postoperative hydronephrosis improvement and other indicators were compared between the two groups.Results:All patients underwent surgery successfully, without conversion to open surgery in LP group. The incidence of postoperative urine leakage and the recovery of hydronephrosis between LP group and OP group 12 months after operation showed no statistically significant difference (P>0.05). The intraoperative bleeding volume, the incidence of postoperative retroperitoneal hematoma, and the postoperative LOS in LP group were lower than those in OP group, while the operation time was longer than that in the OP group, with statistically significant difference (P<0.05).Conclusion:Retroperitoneoscopic dismembered pyeloplasty had similar effect with open dismembered pyeloplasty, but faster recovery and fewer complications, so it has become the preferred treatment method for UPJO in children.
Highlights
Ureteropelvic junction obstruction (UPJO) is the main cause of hydronephrosis in children, and early diagnosis and timely treatment are of great significance to the protection of renal function of children
There are a variety of surgical methods for the treatment of UPJO, of which dismembered pyeloplasty is considered to be the gold standard for the treatment of UPJO with the success rate of over 90% and good long-term efficacy[1,2] after long-term follow-up
The UPJO children hospitalized from January, 2012 to June, 2018 were selected as the study subjects, and divided into OP group and LP group according to surgical methods
Summary
Ureteropelvic junction obstruction (UPJO) is the main cause of hydronephrosis in children, and early diagnosis and timely treatment are of great significance to the protection of renal function of children. If children’s hydronephrosis is not treated or treated incorrectly, renal function will be further impaired. There are a variety of surgical methods for the treatment of UPJO, of which dismembered pyeloplasty is considered to be the gold standard for the treatment of UPJO with the success rate of over 90% and good long-term efficacy[1,2] after long-term follow-up. Pak J Med Sci November - December 2021 Vol 37 No 7 www.pjms.org.pk 1768 development, laparoscopic pyeloplasty has been widely used for its advantages of less pain, less trauma, faster recovery, better cosmetic effect and higher success rate than open surgery. The technique improvement has made retroperitoneoscopic pyeloplasty feasible and effective, even for the infants with UPJ obstruction, and our preliminary experience report is as follows
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