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
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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References
- Laparoscopic transabdominal pyeloplasty in children is feasible irrespective of age.J Urol. 2006; 175: 688-691
- Anderson-hynes pyeloplasty in patients less than 12 months old. Is the laparoscopic approach safe and feasible?.J Endourol. 2014 Aug; 28: 906-908
- Is laparoscopic pyeloplasty for ureteropelvic junction obstruction in infants under 1 Year of age a good option?.Front Pediatr. 2019 Sep 25; 7: 352
- Hydronephrosis in the course of ureteropelvic junction obstruction: an underestimated problem? Current opinions on the pathogenesis, diagnosis and treatment.Adv Clin Exp Med. 2017 Aug; 26: 857-864
- Robot-assisted and laparoscopic repair of ureteropelvic junction obstruction: a systematic review and meta-analysis.Our Urol. 2014; 65: 430-452
- Laparoscopic pyeloplasty: a prospective randomized comparison between the transperitoneal approach and retroperitoeoscopy.J Urol. 2007; 178: 2020-2024
- Meta-analysis of transperitoneal versus retroperitoneal approaches of laparoscopic pyeloplasty for ureteropelvic junction obstruction.J Laparoendosc Adv Surg Tech. 2012 Sep; 22: 658-662
- Laparoscopic transperitoneal pyeloplasty in children from age of 3 years: our clinical outcomes compared with open surgery.J Pediatr Urol. 2013 Apr; 9: 161-168
- Transperitoneal laparoscopic pyeloplasty for primary repair of ureteropelvic junction obstruction in infants and children: comparison with open surgery.J Urol. 2007 Oct; 178: 1579-1583
- Laparoscopic pyeloplasty compared with open pyeloplasty in children.J Endourol. 2007 Aug; 21: 897-902
- Prompt management of anastomotic leak or acute obstruction after minimally invasive pyeloplasty with percutaneous nephrostomy preserves outcomes.J Urol. 2014 Dec; 192: 1716-1719
- Laparoscopic pyeloplasty: evolution of a new gold standard.Urology. 2006 May; 67: 932-936
- Laparoscopic pyeloplasty versus open pyeloplasty for recurrent ureteropelvic junction obstruction in children.J Pediatr Urol. 2016 Dec; 12: 401.e1-401.e6
- Endopyelotomy versus redo pyeoloplasty for management of failed pyeloplasty in children: a single center experience.J Pediatr Surg. 2018 Nov; 53: 2250-2255
- Management of initial pyeloplasty failure.J Urol. 1981 May; 125: 695-697
- Management of the failed pyeloplasty.J Urol. 1996 Aug; 156: 738-740
- Laparoscopic pyeloplasty for ureteropelvic junction obstruction following open pyeloplasty in children.J Laparoendosc Adv Surg Tech. 2015 Oct; 25: 858-863
- Primary laparoscopic pyeloplasty in children: a single-center experience of 279 patients and analysis of possible factors affecting complications.J Pediatr Urol. 2020 Jun; 16: 331.e1-331.e11
- Minimally invasive open dismembered pyeloplasty technique: miniature incision, Muscle-splitting dissection, and nopelvis reduction in children.Asian Journal of Urology. 2019; 6: 290-293
- Minimally invasive open pyeloplasty in children: long-term follow-up.Turkish J Urol. 2020; 46: 393-397
- Laparoscopic vs open pyeloplasty in children: results of a randomized, prospective, controlled trial.J Urol. 2017 Mar; 197: 792-797
- Clinical spectrum of congenital anomalies of kidney and urinary tract in children.Indian Pediatr. 2019. Jul 15; 56: 566-570
- Laparoscopic and robotic pyeloplasty as minimally invasive alternatives to the open approach for the treatment of uretero-pelvic junction obstruction in infants: a multi- institutional comparison of oucomes and learnings curves.World J Urol. 2022 Jan 19; 40: 1049-1056
Article info
Publication history
Published online: October 08, 2022
Accepted:
October 6,
2022
Received in revised form:
August 14,
2022
Received:
April 13,
2022
Identification
Copyright
© 2022 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
