A Multicentric Comparative Study Between Laparoscopic Pyeloplasty and Open Pyeloplasty in Children with Ureteropelvic Junction Obstruction

Abstract

.Laparoscopic Pyeloplasty with its pediatric application was first described by (Peters et al.,1995), from that time till now the surgical hand skill has evolved lead to speed up the operation with Laparoscopy continue to show a preference for the transperitoneal approach, but the feasibility of retroperitoneoscopic pyeloplasty has also been demonstrated effective results. Aim of the study: To compare the Laparoscopic and Open Pyeloplasty in the management of Pediatric Patients with Ureteropelvic Junction Obstruction. Patients & methods: Multicentric comparative prospective study concluded from 1st of October 2018 till 1st of October 2020, fifty patients enrolled in the study. 20 patients (12 male,8 female) undergo LP pyeloplasty with mean age is 11.5 years old in Al_Diwaniya teaching hospital,30 patients (21 male,9 female) undergo OP pyeloplasty with mean age is 4 years old in Al_Diwaniyah teaching hospital and Al_Sader Medical city. Results: The operative time in the LP group was found longer than the OP group (with a mean difference 30min.), with no organ injury, no conversion to OP pyeloplasty, with comparable hospital stay between two groups, less pain, and better cosmetic’s acceptance for LP group.  Conclusion:  Short-term outcome of LP pyeloplasty is comparable to OP pyeloplasty regarding hospital stay, no organ injury, no conversion, less analgesic requirement, and better cosmetics acceptance, which can consider promising gold standard surgical intervention for the repair of UPJO nowadays particularly in pediatric patients