Laparoscopic Transabdominal Pyeloplasty in Children is Feasible Irrespective of Age

Metzelder, Martin L.; Schier, Felix; Petersen, Claus; Truß, Michael C.; Ure, Benno M.

doi:10.1016/s0022-5347(05)00179-5

Cited by 122 publications

(93 citation statements)

References 20 publications

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“…It has been shown that LP is a good treatment option for both very young children (< 1 year) and for elderly people (70 years or older). 23,24 LP has also been shown to be adequate treatment for patients with UPJO in horseshoe kidneys. 25 In large studies the outcomes of LP are very good, ranging from 85 to 100%.…”

Section: Laparoscopic Pyeloplasty (Lp)mentioning

confidence: 99%

Hydronephrosis in the course of ureteropelvic junction obstruction - an underestimated problem?Current opinion on pathogenesis, diagnosis and treatment.

et al. 2017

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Ureteropelvic junction obstruction (UPJO) causes a reduction in the urine flow from the renal pelvis into the ureter. Untreated UPJO may cause hydronephrosis, chronic infection or urolithiasis and will often result in progressive deterioration of renal function. Most cases of UPJO are congenital; however, the disease can be clinically silent until adulthood. Other causes, both intrinsic and extrinsic, are acquired and include urolithiasis, post-operative/inflammatory/ischemic stricture, fibroepithelial polyps, adhesions and malignancy. In the past, the most frequent symptom of UPJO in neonates and infants was a palpable flank mass. Nowadays, thanks to the widespread use of maternal and prenatal ultrasound examinations, asymptomatic hydronephrosis is diagnosed very early. In adults and older children symptoms may include intermittent abdominal or flank pain, nausea, vomiting and hematuria. In addition to high specificity and sensitivity in detecting UPJO, modern technologically advanced equipment such as ultrasound, magnetic resonance imaging and computed tomography provides a lot of information about the function of the affected kidney and the anatomy of the surrounding tissues. Treatment options for UPJO include a wide spectrum of approaches, from active surveillance or minimally invasive endourologic techniques to open, laparoscopic or robotic pyeloplasty. The main goal of therapy is to relieve symptoms and maintain or improve renal function, but it is difficult to define treatment success after UPJO therapy.

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Section: Laparoscopic Pyeloplasty (Lp)mentioning

confidence: 99%

Hydronephrosis in the course of ureteropelvic junction obstruction - an underestimated problem?Current opinion on pathogenesis, diagnosis and treatment.

et al. 2017

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“…The disadvantage of LP is that operative times are significantly higher than open pyeloplasty 11,12 . In particular, laparoscopic suturing particularly for children is challenging and time-consuming and requires a learning curve 11 , however, it significantly improved, even with pediatric LP, with increased experience in previous reports 11,13 .Open pyeloplasty is performed through the retroperitoneal approach, which has the advantage of less risk of intraperitoneal organ injury, postoperative ileus, and avoidance of potential deleterious effects of peritoneal exposure to blood and urine. Although adhesions may occur with urological laparoscopic procedures, the incidence appears lower than would be expected with open exploration 14 .…”

Section: Discussionmentioning

confidence: 99%

“…Although adhesions may occur with urological laparoscopic procedures, the incidence appears lower than would be expected with open exploration 14 . Laparoscopic dismembered pyeloplasty is an acceptable option for UPJO in infants and younger children [13][14][15] . A recent report has demonstrated that laparoscopic dismembered pyeloplasty is technically possible in infants younger than 6 months 16 .…”

Section: Discussionmentioning

confidence: 99%

“…The use of 3-mm trocars are recommended to perform this procedure 15,18 , but we used one 10 mm for camera port and two 5 mm port as we are lacking 5 mm telescope and 3 mm port and grasper as well. Double J catheter placement during LP is another recommendation, since it prevents urinary leakage and obviates the need for a perianastomotic drain 13,19 . In our series, we put JJ stent in all five cases.…”

Section: Discussionmentioning

confidence: 99%

“…In our series, we put JJ stent in all five cases. Metzelder et al 13 described postoperative urine leakage in three of 46 children who underwent LP, two of them requiring operative interventions. We don't have this sorts of complications.…”

Section: Discussionmentioning

confidence: 99%

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