Retroperitoneoscopy‐Assisted Dismembered Pyeloplasty With Single‐Site Plus One Port in Older Children With Congenital Hydronephrosis. Issue 2 (6th January 2022)

• Record Type: Journal Article
• Authors: Tanabe, Kazuya; Nakamura, Shigeru; Hyuga, Taiju; Kubo, Taro; Kawai, Shina; Nakai, Hideo
• Is Part Of: Asian journal of endoscopic surgery. Volume 15:Issue 2(2022)
• Page Start: 335
• Page End: 343
• Publication Date: 2022-01-06
• Subjects: congenital hydronephrosis -- dismembered pyeloplasty -- laparoscopy; Endoscopic surgery -- Periodicals; Endoscopic surgery -- Asia -- Periodicals; 617.05705
• DOI: 10.1111/ases.13021
• Languages: English
• ISSNs: 1758-5902

Abstract

Abstract: Introduction: This study aimed to clarify the advantage of retroperitoneoscopy‐assisted dismembered pyeloplasty with single‐site plus one port (RPSPO) for pediatric congenital hydronephrosis in patients aged ≥7 years. Methods: We retrospectively compared a group of patients aged ≥7 years (study group) with patients aged <7 years (comparison group), who underwent RPSPO between August 2015 and August 2018, in terms of preoperative patient characteristics, intra‐ and perioperative results, and postoperative results. Results: The study group consisted of eight patients. The median body weight at surgery was 27 kg (20–38 kg). The median age at surgery was 102.5 m (87–139 m). The severity of hydronephrosis on the affected side graded by the Society for Fetal Urology grade was grade 3 in one case and grade 2 or less in all other cases. All patients underwent a 99m Tc‐MAG3 renogram. Comparison between the two groups showed significant differences in body weight at surgery ( p = 0.003), age ( p < 0.001), and preoperative hydronephrosis grade ( p = 0.007), but the median length of the skin incision was 20 mm in both groups, with no significant difference ( p = 1.000). Redo pyeloplasty was not required in any patient in either group. Conclusion: RPSPO is an advantageous procedure for older children because it allows precise ureteropelvic neoanastomosis under direct vision and the same wound size as in younger children.