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Latitudes and attitudes: A multinational study of laparoscopic pyeloplasty in children

Published:October 08, 2022DOI:https://doi.org/10.1016/j.jpurol.2022.10.005

      Summary

      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

      Summary Fig. 1
      Graphical AbstractPatients distribution from 4 continents and 11 center. Hospital Italiano (Buenos Aires, Argentina), Hospital Prof. Dr. J.P. Garrahan (Buenos Aires, Argentina), Monash Hospital (Melbourne, Australia), Stollery Children's Hospital (Alberta, Canada), McMaster University (Hamilton, Canada), Hospital Exequiel González Cortés (Santiago, Chile), Great Ormond Street Hospital (London, England), Hôpital Mère-Enfant Chirurgie Infantile (Nantes, France), Fundación Puigvert (Barcelona, Spain), Hospital Saint Joan de Deu (Barcelona, Spain), and Children's Mercy Hospital (Kansas City, Missouri, USA).

      Keywords

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