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Laparoscopic Disconnected Pyeloplasty to Treat Ureteropelvic Junction Obstruction (UPJO) in Children

Jian-Cai Chen1, Qi-Liang Zhang1, Yun-Jin Wang1

  • 1Department of Pediatric Surgery, Fujian Provincial Maternity and Children's Hospital, Fuzhou, Fujian, China (mainland).

Medical Science Monitor : International Medical Journal of Experimental and Clinical Research
|December 2, 2019
PubMed

Insights

Laparoscopic disconnected pyeloplasty is a safe and effective treatment for ureteropelvic junction obstruction (UPJO) in children. This minimally invasive approach offers faster recovery and better cosmetic outcomes compared to traditional open surgery.

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 is the standard surgical treatment for UPJO.
  • Laparoscopic techniques are increasingly being explored for pediatric urological conditions.

Purpose of the Study:

  • To evaluate the safety and clinical effectiveness of laparoscopic disconnected pyeloplasty for UPJO in pediatric patients.
  • To compare the outcomes of laparoscopic pyeloplasty with traditional open pyeloplasty.

Main Methods:

  • Retrospective analysis of 122 pediatric patients with UPJO treated between February 2015 and February 2018.
  • Patients were divided into two groups: laparoscopic surgery (n=69) and open surgery (n=53).
  • Clinical data including success rates, pain management, hospital stay, incision length, and complication rates were analyzed.

Main Results:

  • Laparoscopic pyeloplasty achieved a 100% success rate with no conversions to open surgery.
  • Significantly shorter duration of painkiller use (27.6 vs 58.2 h), hospital stay (7.8 vs 11.5 days), and smaller incision length (1.5 vs 5.2 cm) in the laparoscopic group.
  • Lower incidence of poor wound healing (0% vs 7.5%) in the laparoscopic group; similar rates of ureteral stricture (4.3% vs 3.8%).
  • Improved renal function (glomerular filtration rate) and reduced hydronephrosis (anterior and posterior diameters) at 1-year follow-up in both groups.

Conclusions:

  • Laparoscopic disconnected pyeloplasty is as safe and effective as open surgery for pediatric UPJO.
  • The laparoscopic approach offers advantages of minimal trauma, quicker recovery, and superior cosmetic results.
  • This technique represents a viable alternative for treating UPJO in young children.

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