Hualin Cao1, Huixia Zhou2, Kan Liu3, Lifei Ma1, Dehong Liu1, Tian Tao1, Xiaolong Luo1, Wei Cheng4. 1. Department of Urology, Bayi Children's Hospital Affiliated to The Military General Hospital of Beijing PLA, No. 5 Nan Mencang, Dongcheng District, Beijing, 100700, China. 2. Department of Urology, Bayi Children's Hospital Affiliated to The Military General Hospital of Beijing PLA, No. 5 Nan Mencang, Dongcheng District, Beijing, 100700, China. huixia99999@163.com. 3. Department of Urology/State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital/Chinese PLA Medical Academy, Beijing, 100853, China. 4. Department of Surgery, Beijing United Family Hospital, No. 2 Jiangtai, Chaoyang District, Beijing, 100015, China. karinandwei@hotmail.com.
Abstract
BACKGROUND: Common causes of complications of laparoscopic pyeloplasty in children include anastomotic stricture, poor drainage due to high ureteropelvic anastomosis, and torsion of ureter. Herewith, we described our modified technique of paraumbilical three-port laparoscopic dismembered pyeloplasty (PTLDP) to minimize these complications. PATIENTS AND METHODS: Data from 62 patients (age: 1-180 months, median: 12 months) with ureteropelvic junction obstruction (UPJO) who underwent pyeloplasty using our modified technique of PTLDP between February 2014 and September 2014 at our institution were reviewed. The key steps of our modified method involve identifying the lowest point of the renal pelvis and the lateral aspect of the ureter to guarantee a low pelviureteric and correct orientation anastomosis, and using a 4-0 silk for assistant suturing to avoid crushing of the anastomotic tissue. RESULTS: All surgeries were successfully completed without conversion. Three patients required an accessory port for the anastomosis. All the patients achieved complete clinical or radiologic resolution after the operation. The mean operative time was 103.4 min, and mean estimated blood loss was 14.4 mL. Mean postoperative differential function of affected kidney was 43.0 ± 16.3 % (range 24-100 %), increased from 39.7 ± 18.0 % (range 18-100 %), preoperatively (p < 0.001). The success rate was 100 % at a mean follow-up of 18.3 ± 2.9 (range 13-25) months. CONCLUSIONS: Our modified technique of PTLDP is safe and feasible and to allow high success rate for the treatment of pelviureteric junction obstruction in children.
BACKGROUND: Common causes of complications of laparoscopic pyeloplasty in children include anastomotic stricture, poor drainage due to high ureteropelvic anastomosis, and torsion of ureter. Herewith, we described our modified technique of paraumbilical three-port laparoscopic dismembered pyeloplasty (PTLDP) to minimize these complications. PATIENTS AND METHODS: Data from 62 patients (age: 1-180 months, median: 12 months) with ureteropelvic junction obstruction (UPJO) who underwent pyeloplasty using our modified technique of PTLDP between February 2014 and September 2014 at our institution were reviewed. The key steps of our modified method involve identifying the lowest point of the renal pelvis and the lateral aspect of the ureter to guarantee a low pelviureteric and correct orientation anastomosis, and using a 4-0 silk for assistant suturing to avoid crushing of the anastomotic tissue. RESULTS: All surgeries were successfully completed without conversion. Three patients required an accessory port for the anastomosis. All the patients achieved complete clinical or radiologic resolution after the operation. The mean operative time was 103.4 min, and mean estimated blood loss was 14.4 mL. Mean postoperative differential function of affected kidney was 43.0 ± 16.3 % (range 24-100 %), increased from 39.7 ± 18.0 % (range 18-100 %), preoperatively (p < 0.001). The success rate was 100 % at a mean follow-up of 18.3 ± 2.9 (range 13-25) months. CONCLUSIONS: Our modified technique of PTLDP is safe and feasible and to allow high success rate for the treatment of pelviureteric junction obstruction in children.
Authors: Lieneke J Draaijers; Fenike R H Tempelman; Yvonne A M Botman; Wim E Tuinebreijer; Esther Middelkoop; Robert W Kreis; Paul P M van Zuijlen Journal: Plast Reconstr Surg Date: 2004-06 Impact factor: 4.730
Authors: Ziho Lee; Jay Simhan; Daniel C Parker; Christopher Reilly; Elton Llukani; David I Lee; Jack H Mydlo; Daniel D Eun Journal: Urology Date: 2013-09 Impact factor: 2.649
Authors: G P Ding; S D Cheng; D Fang; K L Yang; X S Li; H X Zhou; Q Zhang; X J Ye; L Q Zhou Journal: Beijing Da Xue Xue Bao Yi Xue Ban Date: 2019-08-18