Comparison of laparoscopic-assisted versus open dismembered pyeloplasty for ureteropelvic junction obstruction in infants: intermediate results
Related Experiment Video
Updated: Jun 21, 2026
Transmesenteric Laparoscopic Pyeloplasty in Trendelenburg Position for Horseshoe Kidney with Hydronephrosis
Published on: July 8, 2025
Qiangsong Tong1, Liduan Zheng, Shaotao Tang
1Department of Pediatric Surgery, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, People's Republic of China. qs_tong@hotmail.com
Objectives:
To compare the results of laparoscopic-assisted dismembered pyeloplasty (LADP) with open dismembered pyeloplasty in infants. LADP is an innovative minimally invasive technique to mobilize and exteriorize the ureteropelvic junction for Anderson-Hynes dismembered pyeloplasty.
Methods:
A total of 23 infants (mean 7.3 months, range 2-11) underwent LADP via the retroperitoneal approach. An additional 21 children (mean 8.2 months, range 3-12) underwent similar procedures via open surgery. We retrospectively compared the operative time, hospital stay, postoperative complications, and follow-up.
Results:
Patient demographic data were similar between the 2 groups. Mean operative time was significantly shorter in the open surgery than the LADP group (95.4 vs 102.6 minutes, P <.05). The mean incision length (2 vs 5 cm), recovery of intestinal function (24.3 vs 48.2 hours), and postoperative hospital stay (2.5 vs 5 days) were better in the LADP group than in the open group (P <.01). No intraoperative complications occurred in either group. Mean follow-up was 19 (range 6-36) and 24 (range 12-48) months in the LADP and open surgery groups, respectively. The incidence of postoperative complications (3 of 23, 13.0% vs 3 of 21, 14.3%; P = .33) and success rates (22 of 23, 95.7% vs 20 of 21, 95.2%; P = .51) were equivalent in the 2 groups.
Conclusions:
Shorter hospital stay, early recovery, and better cosmetic results may be the advantages of LADP over open surgery in small infants, which should be confirmed by a prospective and randomized study.
