Comparison of Dismembered and Nondismembered Laparoscopic Pyeloplasty in the Pediatric Patient

Casale, Pasquale; Grady, Richard W.; Joyner, Byron D.; Zeltser, Ilia S.; Figueroa, T. Ernesto; Mitchell, Michael E.

doi:10.1089/end.2004.18.875

Cited by 72 publications

(40 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…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

View full text Add to dashboard Cite

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.

show abstract

Section: -7supporting

confidence: 80%

Study comparing the applicability of dorsal lumbotomy in older children

Cloutier

Haidar

Rompre-Deschenes

et al. 2012

CUAJ

View full text Add to dashboard Cite

show abstract

“…Regarding the recently published literature for laparoscopic pyeloplasty, success rates are reported up to 100 % with low complication rates [4,7,18,25,26]. We, however, stress the fact that the laparoscopic technique still represents a technically challenging procedure even in adult patients.…”

Section: Discussionmentioning

confidence: 86%

“…If aganglionic (dysfunctional) segments are suspected in the development of a UPJO, a Y-V plasty is justified and this corresponds to a three-fourth AndersonHynes plasty including spatulation of the ureter. To our knowledge, there is only one study that compared dismembered and non-dismembered laparoscopic pyeloplasty for the treatment of UPJO in children, reporting significant advantage for the dismembered technique (94 % dismembered vs. 43 % non-dismembered) [7]. However, non-dismembered pyeloplasty was not performed in children in case of a crossing vessel and therefore not considered for this evaluation.…”

Section: Discussionmentioning

confidence: 99%

“…With growing experience in laparoscopic techniques, there has gradually been a transition in paediatric surgery from ablative techniques to reconstructive procedures. Besides the established procedures like the laparoscopic nephrectomy and orchidopexy, procedures such as heminephrectomy and pyeloplasty have also proven to be applicable and feasible in both children and infants, respectively [4][5][6][7][8][9][10][11][12][13][14][15][16]. Penn et al found near equal results regarding outcomes in a comparative study laparoscopic pyeloplasty versus open approach [3].…”

Section: Introductionmentioning

confidence: 99%

“…dismembered and non-dismembered pyeloplasty) with success rates of more than 90 %. Casale et al [7] reported on 26 children who underwent both a dismembered and non-dismembered laparoscopic pyeloplasty. The non-dismembered pyeloplasty was performed by Heineke-Mikulicz technique with a poor success rate of 43 %.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Dismembered and non-dismembered retroperitoneoscopic pyeloplasty for the treatment of ureteropelvic junction obstruction in children

et al. 2012

View full text Add to dashboard Cite

Purpose Open dismembered pyeloplasty according to Anderson-Hynes (AHP) is the gold standard treatment for ureteropelvic junction obstruction in children. However, during the last decade, the management has been revolutionized with introduction of laparoscopy and endourology yielding comparable results and less morbid outcomes. Methods Between 1997 and 2010, dismembered and nondismembered retroperitoneoscopic pyeloplasty was performed in 41 children with a median age of 130 month (range 5-192). 20 children underwent a dismembered pyeloplasty (Anderson-Hynes) and 21 children were operated by a non-dismembered pyeloplasty (Y-V-Plasty). Results The mean operation time was 120 min (range 52-257). Intraoperative findings revealed in 29 cases a significant crossing vessel. Based on a furosemide nephrogram and subjective complaints, the success rate was 88 % with a median follow-up of 69 month (range 14-142). The 5 failures (2 Y-V-Plasty, 3 AHP) have been treated by open AHP (n = 2), Laser endopyelotomy (n = 2) and Lap-AHP (n = 1) without further problems. Conclusion With increasing improvement of the suture techniques, the laparoscopic pyeloplasty represents in experienced hands an alternative method with comparable success rates to the open technique. In our opinion, retroperitoneoscopic pyeloplasty is technically possible and feasible even in infants. We found in our series no statistically significant difference between dismembered and non-dismembered pyeloplasty.

show abstract

Laparoscopic and Robotic Pyeloplasty in Children

Peters

2012

Smith's Textbook of Endourology

View full text Add to dashboard Cite

Comparison of Dismembered and Nondismembered Laparoscopic Pyeloplasty in the Pediatric Patient

Abstract: Patients with a large, symptomatic Type 2 caliceal diverticulum with thin overlying parenchyma are ideal candidates for laparoscopic intervention. The laparoscopic technique of caliceal diverticulum ablation in the pediatric population is feasible in appropriate patients.

Cited by 72 publications

References 16 publications

Study comparing the applicability of dorsal lumbotomy in older children

Study comparing the applicability of dorsal lumbotomy in older children

Dismembered and non-dismembered retroperitoneoscopic pyeloplasty for the treatment of ureteropelvic junction obstruction in children

Laparoscopic and Robotic Pyeloplasty in Children

Contact Info

Product

Resources

About