Latitudes and attitudes: A multinational study of laparoscopic pyeloplasty in children.
Document Type
Article
Publication Date
2-2023
Identifier
DOI: 10.1016/j.jpurol.2022.10.005
Abstract
PURPOSE: The Anderson-Hynes technique has been the treatment of choice for primary ureteropelvic junction obstruction in children. Laparoscopic approach has shown similar outcomes to open, with advantages of shorter hospital stay and less pain. We reviewed the experience of 11 geographically diverse, tertiary pediatric urology institutions focusing on the outcomes and complications of laparoscopic pyeloplasty.
MATERIALS AND METHODS: A descriptive, retrospective study was conducted evaluating patients undergoing Anderson-Hynes dismembered laparoscopic pyeloplasty. Centers from four different continents participated. Demographic data, perioperative management, results, and complications are described.
RESULTS: Over a 9-year period, 744 laparoscopic pyeloplasties were performed in 743 patients. Mean follow-up was 31 months (6-120m). Mean age at surgery was 82 months (1 w-19 y). Median operative time was 177 min. An internal stent was placed in 648 patients (87%). A catheter was placed for bladder drainage in 702 patients (94%). Conversion to open pyeloplasty was necessary in seven patients. Average length of hospital stay was 2.8 days. Mean time of analgesic requirement was 3.2 days. Complications, according to Clavien-Dindo classification, were observed in 56 patients (7.5%); 10 (1%) were Clavien-Dindo IIIb. Treatment failure occurred in 35 cases with 30 requiring redo pyeloplasty (4%) and 5 cases requiring nephrectomy (0.6%).
CONCLUSION: We have described the laparoscopic pyeloplasty experience of institutions with diverse cultural and economic backgrounds. They had very similar outcomes, in agreement with previously published data. Based on these findings, we conclude that laparoscopic pyeloplasty is safe and successful in diverse geographics areas of the world.
Journal Title
J Pediatr Urol
Volume
19
Issue
1
First Page
86.e1
Last Page
86.e6
MeSH Keywords
Child; Humans; Attitude; Kidney Pelvis; Laparoscopy; Retrospective Studies; Treatment Outcome; Ureteral Obstruction; Urologic Surgical Procedures
Keywords
Attitude; Kidney Pelvis; Laparoscopy; Retrospective Studies; Treatment Outcome; Ureteral Obstruction; Urologic Surgical Procedures
Recommended Citation
Echeverria P, Reed L F, Gatti JM, et al. Latitudes and attitudes: A multinational study of laparoscopic pyeloplasty in children. J Pediatr Urol. 2023;19(1):86.e1-86.e6. doi:10.1016/j.jpurol.2022.10.005
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