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Outcome analysis of immediate and delayed laparoscopic pyeloplasty in infants with severe ureteropelvic junction

Qiao Bao1, Weijun Ma1, Xiewu Zhang1

  • 1Department of Pediatric Urology, Guangdong Women and Children Hospital, Guangzhou, China.

Frontiers in Pediatrics
|November 7, 2022
PubMed

Insights

Immediate laparoscopic pyeloplasty for infants with severe ureteropelvic junction obstruction (UPJO) leads to faster recovery of renal morphology compared to delayed treatment. This approach accelerates the improvement of key indicators in infants with UPJO-induced hydronephrosis.

Area of Science:

  • Pediatric Surgery
  • Urology
  • Medical Imaging

Background:

  • Ureteropelvic junction obstruction (UPJO) in infants presents a controversial treatment timing dilemma.
  • Severe UPJO can lead to significant hydronephrosis, necessitating timely intervention.

Purpose of the Study:

  • To compare the renal morphology recovery effects of immediate versus delayed laparoscopic pyeloplasty in infants with severe UPJO.
  • To evaluate the impact of surgical timing on key renal morphological indices.

Main Methods:

  • Retrospective analysis of 135 infants with severe UPJO-induced hydronephrosis treated between 2010-2019.
  • Patients were divided into immediate treatment (IT, ≤1 month) and delayed treatment (LT, 3-6 months) groups.
  • Renal morphology assessed via ultrasonography (pelvic anteroposterior diameter, parenchymal thickness, polar length, SFU grade) preoperatively and at 6, 12, 24 months postoperatively.

Main Results:

  • Both IT and LT groups showed renal morphology recovery, but the IT group demonstrated significantly greater improvement in APD, PT, and PL.
  • The reduction in SFU grade was more significant in the IT group over the 24-month follow-up.
  • While not significant at 6 months, polar length and APD were significantly greater in the IT group at 12 and 24 months.

Conclusions:

  • Immediate laparoscopic pyeloplasty is an effective treatment for severe UPJO in infants.
  • Early surgical intervention accelerates the recovery of renal morphological indices in infants with severe UPJO-induced hydronephrosis.
Abstract

Keywords:
delayedimmediateinfantlaparoscopic pyeloplastyureteropelvic junction obstruction

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