Objective: To investigate the clinical application of retroperitoneoscopic dismembered pyeloplasty for pediatric ureteropelvic junction obstruction (UPJO).
Methods: Of the 85 pediatric patients with UPJO, 56 were boys and 29 were girls. The age of the patients ranged from 2.5 to 11 years (mean = 4.6 years).B-ultrasonography showed hydronephrosis <15 mm (mild) in 15 patients,15-30 mm (moderate) in 59, <30 mm (severe) in the other 6. Intravenous urography (IVU) showed good imaging in 55 patients within 30 min, light imaging in 27 at 30-120 min, and no imaging in 3 after 120 min. The 85 patients underwent retroperitoneoscopic dismembered pyeloplasty. Conventional antegrade or modified antegrade double-J stenting was inserted in the 85 patients intraoperatively.
Results: The operation was successful in all, with no conversion to open surgery during the operation. The mean operation time was 146 min (125-240 min).The mean blood loss was 68 mL (55-112 mL).The mean postoperative hospitalization was 7 d (6-8 d ).Urine leakage occurred in 1 patient and with a good drainage, urine leakage disappeared in 1 week. Follow-up ranged 3-24 months (mean = 11 months).IVU showed on UPJ stricture, and good imaging in 75 patients within 30 min, light imaging in 10 at 30-120 min. Hydronephrosis was remitted:hydronephrosis resolution in 51 patients, mild in 6 and moderate in 3.
Conclusion: Retroperitoneoscopic dismembered pyeloplasty is a safe, effective and mini-invasive procedure for pediatric ureteropelvic junction obstruction, with a rapid postoperative recovery. It will be the ideal treatment for UPJO in pediatric patients.
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