OBJECTIVE: To present our initial clinical experience with laparoendoscopic single-site surgery (LESS) for ureteropelvic junction obstruction (UPJO) in the pediatric age group. MATERIAL AND METHODS: Between January and December 2009, 11 consecutive pediatric patients underwent treatment of primary UPJO via a laparoscopic approach. All patients underwent LESS-pyeloplasty. Radiographic success was defined as improvement of hydronephrosis with a patent UPJ on intravenous urography, or improved drainage on diuretic renal scan. RESULTS: The mean age of patients was 10 (2-17) years. Crossing lower pole vessel and severe adhesion were found in three (27%) and eight (73%) cases, respectively. The mean operating-room time was 182.5 (160-300) min, and the mean estimated blood loss, including urine, was 97.3 (80-160) mL. Mean hospital stay was 2 (1-3) days. Wound infection at port site and urinary infection occurred in one case each. All parents seem extremely satisfied with postoperative cosmetic outcome. The success rate was 100%. CONCLUSION: Preliminary experience with LESS-pyeloplasty in children suggests that outcomes are comparable to conventional laparoscopic surgery but with improved cosmesis; however, a larger study is necessary to confirm these findings and to determine if there are any benefits in postoperative pain or recovery.
OBJECTIVE: To present our initial clinical experience with laparoendoscopic single-site surgery (LESS) for ureteropelvic junction obstruction (UPJO) in the pediatric age group. MATERIAL AND METHODS: Between January and December 2009, 11 consecutive pediatric patients underwent treatment of primary UPJO via a laparoscopic approach. All patients underwent LESS-pyeloplasty. Radiographic success was defined as improvement of hydronephrosis with a patent UPJ on intravenous urography, or improved drainage on diuretic renal scan. RESULTS: The mean age of patients was 10 (2-17) years. Crossing lower pole vessel and severe adhesion were found in three (27%) and eight (73%) cases, respectively. The mean operating-room time was 182.5 (160-300) min, and the mean estimated blood loss, including urine, was 97.3 (80-160) mL. Mean hospital stay was 2 (1-3) days. Wound infection at port site and urinary infection occurred in one case each. All parents seem extremely satisfied with postoperative cosmetic outcome. The success rate was 100%. CONCLUSION: Preliminary experience with LESS-pyeloplasty in children suggests that outcomes are comparable to conventional laparoscopic surgery but with improved cosmesis; however, a larger study is necessary to confirm these findings and to determine if there are any benefits in postoperative pain or recovery.
Authors: Stephen Faddegon; Yung K Tan; Ephrem O Olweny; Samuel K Park; Sara L Best; Jeffrey A Cadeddu Journal: JSLS Date: 2012 Jan-Mar Impact factor: 2.172