Mini-laparoscopic pyeloplasty to treat UPJO in infants
Xu Cui1, Yuan-Bin He1, Wen-Hua Huang1
1Department of Pediatric Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, People's Republic of China.
Insights
Mini-laparoscopic pyeloplasty offers a safe and effective alternative for infant ureteropelvic junction obstruction (UPJO). This minimally invasive approach demonstrates comparable clinical outcomes to open surgery with enhanced recovery and cosmetic benefits.
Area of Science:
- Pediatric Surgery
- Urology
- Minimally Invasive Surgery
Background:
- Ureteropelvic junction obstruction (UPJO) is a common cause of hydronephrosis in infants.
- Traditional open pyeloplasty is effective but associated with significant postoperative morbidity.
- Minimally invasive techniques are increasingly explored to improve surgical outcomes in pediatric patients.
Purpose of the Study:
- To evaluate the safety and clinical efficacy of mini-laparoscopic pyeloplasty in infants with UPJO.
- To compare mini-laparoscopic pyeloplasty with open pyeloplasty in terms of surgical outcomes and recovery.
Main Methods:
- Retrospective analysis of 66 infants diagnosed with UPJO between January 2013 and August 2018.
- Patients were divided into two groups: mini-laparoscopic pyeloplasty (Group A) and open pyeloplasty (Group B).
- Comparison of perioperative parameters, complication rates, and long-term functional outcomes.
Main Results:
- Mini-laparoscopic pyeloplasty group showed significantly reduced bleeding, shorter analgesia and hospitalization durations, and smaller incision lengths compared to open surgery (p < .05).
- Incision dehiscence occurred in 0% of the mini-laparoscopic group versus 11.7% in the open surgery group (p = .045).
- Postoperative anastomotic stenosis rates were similar between groups (6.2% vs. 5.9%, p = .719), and both groups showed significant improvement in renal function at one year.
Conclusions:
- Mini-laparoscopic pyeloplasty is a safe and effective treatment for infant UPJO, yielding comparable early clinical efficacy to open surgery.
- The procedure offers advantages including fewer incisions, reduced pain, faster recovery, and improved cosmetic results.
- Mini-laparoscopic pyeloplasty represents a favorable surgical option for UPJO in the pediatric population.
Purpose:
The aim of this study was to investigate the safety and clinical efficacy of mini-laparoscopic pyeloplasty in treating ureteropelvic junction obstruction (UPJO) in infants.
Material And Methods:
We retrospectively analysed the clinical data of 66 infants with UPJO from January 2013 to August 2018 at our hospital. They were divided into the laparoscopic surgery group (group A) and the open surgery group (group B), depending on the surgical method.
Results:
The bleeding volume, analgesia duration, postoperative hospitalization duration, and incision length in group A were significantly less than those in group B (p < .05). The incidence of incision dehiscence was 0% in group A and 11.7% in group B (p = .045). At the postoperative follow-up, the incidence of anastomotic stenosis was 6.2% in group A and 5.9% in group B (p = .719). The anteroposterior diameter and glomerular filtration rate were significantly improved at the one-year follow-up, but there was no significant difference between the groups (p > .05).
Conclusions:
Mini-laparoscopic pyeloplasty to treat UPJO in infants has the same early clinical efficacy and safety as open surgery, and this procedure has the advantages of fewer incisions, less pain, quicker recovery, and better cosmetic outcomes.
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