Transperitoneal Laparoscopic Pyeloplasty in Children

Singh, Harprit; Ganpule, Arvind; Malhotra, Vineet; Manohar, T.; Muthu, Veeramani; Desai, Mahesh

doi:10.1089/end.2007.0023

Cited by 24 publications

(8 citation statements)

References 20 publications

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“…In laparoscopy, often a double J stent is used, which requires general anesthesia. [5][6][7]12 Even though we used a stringent criteria to define a successful outcome, our success rate was similar in both groups (90%), which is comparable to the overall literature. 1,5,8 It is understood that one cannot offer an open dorsal lumbotomy to all children over 5 and that our results in the older group are based on a mean BMI of 17.5 (which could be an influencing factor).…”

Section: -7supporting

confidence: 80%

Study comparing the applicability of dorsal lumbotomy in older children

Cloutier

Haidar

Rompre-Deschenes

et al. 2012

CUAJ

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Objective: Dismembered pyeloplasty through dorsal lumbotomy to correct ureteropelvic junction obstruction is mainly successfully performed in children under 5 years old for technical reasons. We compared children who underwent dorsal lumbotomy by age group (<5 vs. ≥5 years old) to determine if the surgical success and long-term results were comparable. Materials and Methods:We retrospectively reviewed the charts of 134 children undergoing a pyeloplasty. Group 1 consisted of children <5 years old (n = 90) and Group 2 consisted of children ≥5 years old. Patients' characteristics, as well as hospital stay, narcotic use, radiologic follow-up and success rate, were compared. Success was defined by absence of symptoms and ≥50% reduction in renal pelvis anteroposterior diameter and/or scintigraphic normalization of the drainage T1/2 when obtained. Univariate analysis was performed to compare the groups. Results: Mean age (years) and weight (kg) at surgery for Groups 1 and 2 were 1/8 kg and 11/35 kg, respectively. Mean operative time was 98 minutes versus 120 minutes, respectively; mean hospital stay was 2.5 days for both groups and analgesia requirement was 50% higher in Group 2. A Pippi-Salle stent was used in 90% (n = 120) of cases. Mean follow-up was 26 months and the success rate was 89% and 90% for Groups 1 and 2, respectively. Conclusion: Our study showed comparable success rates. We can infer that, as a technique, dismembered pyeloplasty is effective and safe in the younger and older children.

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Section: -7supporting

confidence: 80%

Study comparing the applicability of dorsal lumbotomy in older children

Cloutier

Haidar

Rompre-Deschenes

et al. 2012

CUAJ

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“…Singh et al [13] reporting on their series of 16 children had no major intraoperative complications. Postoperatively, one child had a urinary tract infection that necessitated hospital admission and administration of intravenous antibiotics.…”

Section: Discussionmentioning

confidence: 94%

Complications of laparoscopic pyeloplasty in children

et al. 2009

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“…Although a head-on comparison between standard laparoscopy and LESS in a pediatric population was beyond the scope of this study, we have eluded to our anecdotal experience with standard laparoscopic pyeloplasty in children [13]. The results of LESS match those of standard pyeloplasty done at our center.…”

Section: Discussionmentioning

confidence: 93%

Laparoendoscopic Single-Site Urologic Surgery in Children Less Than 5 Years of Age

et al. 2013

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PurposeWe report our experience with laparoendoscopic single-site (LESS) urological procedures in children less than 5 years of age.Materials and MethodsTen patients (11 procedures) underwent LESS through the umbilicus. Seven patients underwent nephrectomy and three patients underwent pyeloplasty (one simultaneous bilateral). R-port port (Advanced Surgical Concepts, Ireland) was used in nine cases, in one case, the Gelpoint access port (Applied Medical, Rancho Santa Margarita, CA, USA) was used. The Olympus Endoeye camera with coaxial light cable was used. The hilum was secured in all cases with Hem-o-Lok clips (Teleflex Medical, Research Triangle Park, NC, USA) except in one case in which an Endo GIA stapler (Covidien Surgical, Norwalk, CT, USA) was used.ResultsAll procedures were technically successful. Accessory port (3 mm) was used in 3 patients. Mean age in nephrectomized patients was 3.14±1.7 years, the mean operative room time (ORT) was 97.5±12.54 minutes. In the pyeloplasty group, mean ORT was 192±47.16 minutes and mean age was 2.43±2.3 years. Bilateral pyeloplasty was done in a 4-month-old infant. The ORT in this case was 180 minutes. A follow-up renogram done in the pyeloplasty patients (n=2) showed good drainage. Mean length of stay was 3.6 days (range, 3 to 6 days).The analgesic requirement was 23.86 mg (range, 12.5 to 50 mg) of diclofenac sodium.ConclusionsLESS is technically feasible in patients as young as 4 months of age. It has the potential to offer better cosmesis. This needs to be proved in further comparative studies. Development of miniature instruments will further the growth of LESS in this age group.

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Transperitoneal Laparoscopic Pyeloplasty in Children

Abstract: Laparoscopic pyeloplasty in children is a safe, minimally invasive treatment option that duplicates the principles and techniques of definitive open surgical repair. It is technically challenging; with increasing expertise, operative times are reduced significantly.

Cited by 24 publications

References 20 publications

Study comparing the applicability of dorsal lumbotomy in older children

Study comparing the applicability of dorsal lumbotomy in older children

Complications of laparoscopic pyeloplasty in children

Laparoendoscopic Single-Site Urologic Surgery in Children Less Than 5 Years of Age

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