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Published on: July 8, 2025
Functional Results of Laparoscopic Pyeloplasty in Children: Single Institute Experience in Long Term
Halil Ciftci1, Yigit Akin, Murat Savas
1Department of Urology, Harran University School of Medicine, Sanliurfa, Turkey.
Insights
Laparoscopic pyeloplasty (LP) is a safe and effective treatment for childhood ureteropelvic junction obstruction (UPJO), showing good long-term functional outcomes. This minimally invasive approach achieved a 91% success rate in a single institute study.
Area of Science:
- Pediatric Urology
- Minimally Invasive Surgery
- Surgical Outcomes
Background:
- Ureteropelvic junction obstruction (UPJO) is a common cause of congenital hydronephrosis in children.
- Traditional open pyeloplasty can be associated with significant morbidity.
- Laparoscopic pyeloplasty (LP) has emerged as a less invasive alternative.
Purpose of the Study:
- To evaluate the long-term functional outcomes of laparoscopic pyeloplasty (LP) in pediatric patients.
- To assess the safety and efficacy of LP for ureteropelvic junction obstruction (UPJO) in a single institute.
Main Methods:
- A retrospective review of a laparoscopy database for pediatric LP cases (June 2008 - April 2015).
- Data collected included patient demographics, operative details (operative time, estimated blood loss), and complications (Clavien classification).
- Long-term functional outcomes were assessed using renal ultrasonography and diethylenetriamine penta-acetate (DTPA) scintigraphy at 3, 12, and 24 months post-surgery.
Main Results:
- A total of 153 pediatric patients with UPJO underwent LP, with a mean follow-up of 34 months.
- The overall success rate was 91%, with a significant increase in split renal function observed on DTPA scintigraphy.
- Complications included anastomotic leakage (Clavien 1) in 13 patients and 8 cases requiring conversion to open pyeloplasty (Clavien 3b).
Conclusions:
- Laparoscopic pyeloplasty (LP) is a safe and effective surgical option for treating childhood ureteropelvic junction obstruction (UPJO).
- The procedure demonstrates favorable long-term functional outcomes, particularly when performed by experienced surgeons in specialized centers.
Objective:
The aim of this study was to evaluate the long-term functional outcomes of laparoscopic pyeloplasty (LP) in children for consecutive cases of single institute.
Materials And Methods:
Our laparoscopy database was investigated for children in terms of LP between June 2008 and April 2015. All the patients had ureteropelvic junction obstruction (UPJO) and LP was performed. Demographic data including age, gender, side of UPJO, operation time, estimated blood loss (EBL), hospital stay and complications according to Clavien classifications were recorded. Renal ultrasonography and diethylenetriamine penta-acetate (DTPA) scintigraphies were respectively performed 3, 12 and 24 months after surgery. Statistical analyses were performed and p value was accepted as significant at <0.05.
Result:
Mean follow-up was 34 ± 4.7 months. The mean age was 13 (6-72) months. A total of 153 (110 boys and 43 girls) LP patients enrolled. Of that, 93 (60.78%) LP were in left side and 60 (39.21%) were in right side. Three cases needed open conversation according to difficulties in anastomosis. Aberrant crossing vessel was observed in 12 (7.84%) patients. The mean operation time was 155 ± 21 min and the mean EBL was 22 ± 11.1 ml. The mean hospital stay was 3.4 days. Anastomotic leakage was the common complication (in 13 patients) that was successfully managed conservatively (Clavien 1). Eight patients experienced unsuccessful LP and underwent open pyeloplasty (Clavien 3b). The mean split renal function significantly increased in DTPA scintigraphy in follow-up. The overall success was 91%.
Conclusions:
The LP procedure can be an effective and safe surgical method for childhood UPJO, specifically in the experienced hands of pioneer centers.
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