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Minimally invasive open pyeloplasty in children: Long-term follow-up

Farshid Alizadeh1, Saeid Haghdani2, Behnaz Seydmohammadi1

  • 1Kidney Transplantation Research Center, Isfahan University of Medical Sciences (IUMS), Isfahan, Iran.

Turkish Journal of Urology
|May 26, 2020
PubMed

Insights

Minimally invasive open pyeloplasty is a safe and effective procedure for children with ureteropelvic junction obstruction, showing a high success rate and minimal complications. Long-term follow-up is crucial for assessing outcomes in pediatric pyeloplasty surgery.

Area of Science:

  • Pediatric Urology
  • Minimally Invasive Surgery
  • Urology

Background:

  • Ureteropelvic junction (UPJ) obstruction is a common cause of congenital hydronephrosis in children.
  • Traditional open pyeloplasty can involve larger incisions and longer recovery times.
  • Minimally invasive techniques aim to reduce surgical morbidity while maintaining efficacy.

Purpose of the Study:

  • To evaluate the long-term outcomes of a miniature open pyeloplasty technique in pediatric patients.
  • To assess the safety, efficacy, and complication rates of this approach.
  • To determine the success rate and recurrence patterns over an extended follow-up period.

Main Methods:

  • A cohort of 213 children with UPJ obstruction underwent miniature open pyeloplasty.
  • The Anderson-Hynes dismembered pyeloplasty was performed via a subcostal miniature incision.
  • Intraoperative and postoperative parameters, including operative time, incision length, blood loss, analgesic use, hospital stay, complications, and success rates, were meticulously documented.

Main Results:

  • The procedure demonstrated a high success rate of 98.1% with a mean follow-up of 21.43 months.
  • Mean operative time was 65 minutes with a mean incision size of 16.99 mm.
  • No patients required blood transfusions or narcotic analgesics; mean hospital stay was 21.97 hours. Minor complications included UTI (3.8%) and one case of urinary leakage (0.004%), with no major complications observed.

Conclusions:

  • Miniature open pyeloplasty is a safe and highly effective minimally invasive option for pediatric UPJ obstruction.
  • This technique offers advantages in terms of reduced complications and shorter hospital stays compared to other minimally invasive methods.
  • Long-term patient follow-up is essential for comprehensive evaluation of pyeloplasty outcomes.
Abstract

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