Laparoscopic pyeloplasty in children: Is the outcome different in children under 2 years of age?

Abstract 

Purpose

To report the outcomes of a series of children younger than 2 years with ureteropelvic junction obstruction (UPJO) who underwent laparoscopic pyeloplasty (LP), compared to children older than 2 years.

Patients and methods

Twenty-three children (18 male) with UPJO underwent 24 Anderson–Hynes transperitoneal LPs between March 2003 and July 2007. The diagnosis of UPJO was confirmed on renal sonography and diuretic renogram. Nine children were younger than 2 years (Group 1) and 14 were older (Group 2). One child had bilateral UPJO and underwent two non-simultaneous procedures. All children were investigated with postoperative diuretic renogram and renal sonography, and the results were statistically analysed.

Results

LP was feasible without conversions or intraoperative complications in all 24 cases. Median age in Groups 1 and 2 was 11 months (4–24) and 74 months (27–204), respectively, (P<0.00001). No differences were found between the groups regarding median operative time, complications, technical difficulties, discharge home and follow-up. All patients in both groups experienced resolution of symptoms or obstruction.

Conclusions

The LP in children younger than 2 years is highly successful with a low-rate of complications, and has the same outcomes as in older children.

Keywords: Pyeloplasty, Children, Laparoscopy, Ureteropelvic junction