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Reoperative Laparoscopic Ureteropelvic Junction Obstruction Repair in Children: Safety and Efficacy of the Technique

2016; Lippincott Williams & Wilkins; Volume: 197; Issue: 3 Part 1 Linguagem: Inglês

10.1016/j.juro.2016.10.062

1527-3792

Paulo Renato Marcelo Moscardi, João Arthur Brunhara Alves Barbosa, Hiury S. Andrade, Marcos Figueiredo Mello, Bruno Nicolino Cezarino, Lorena Marçalo Oliveira, Miguel Srougi, Francisco Tibor Dénes, Roberto Iglesias Lopes,

Kidney Stones and Urolithiasis Treatments

No AccessJournal of UrologyPediatric Urology1 Mar 2017Reoperative Laparoscopic Ureteropelvic Junction Obstruction Repair in Children: Safety and Efficacy of the Technique Paulo Renato Marcelo Moscardi, João Arthur Brunhara Alves Barbosa, Hiury Silva Andrade, Marcos Figueiredo Mello, Bruno Nicolino Cezarino, Lorena Marçalo Oliveira, Miguel Srougi, Francisco Tibor Dénes, and Roberto Iglesias Lopes Paulo Renato Marcelo MoscardiPaulo Renato Marcelo Moscardi , João Arthur Brunhara Alves BarbosaJoão Arthur Brunhara Alves Barbosa , Hiury Silva AndradeHiury Silva Andrade , Marcos Figueiredo MelloMarcos Figueiredo Mello , Bruno Nicolino CezarinoBruno Nicolino Cezarino , Lorena Marçalo OliveiraLorena Marçalo Oliveira , Miguel SrougiMiguel Srougi , Francisco Tibor DénesFrancisco Tibor Dénes , and Roberto Iglesias LopesRoberto Iglesias Lopes View All Author Informationhttps://doi.org/10.1016/j.juro.2016.10.062AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Failure after pyeloplasty for ureteropelvic junction obstruction in children may occur in up to 10% of cases. Therapeutic options include Double-J® stent placement, endoscopic treatment and reoperation. Laparoscopic and robotic reoperative modalities seem safe and efficacious, although pediatric series are limited in the literature. We report the largest known series of reoperative laparoscopic ureteropelvic junction obstruction repair in children and compare this approach to primary laparoscopic pyeloplasty. Materials and Methods: We reviewed all children undergoing laparoscopic pyeloplasty at a single institution from 2004 to 2015. Reoperative laparoscopic ureteropelvic junction obstruction repair was compared to primary pyeloplasty. Groups were analyzed regarding demographics, operative time, complications, length of hospital stay and success, defined by improvement of symptoms, ultrasound and renogram. Results: We identified 11 cases of reoperation (8 redo pyeloplasties and 3 ureterocalycostomies) and 71 primary pyeloplasties. Groups were not different in age, gender or weight. Median followup was 37 months. Median time between primary pyeloplasty and reoperation was 34 months. Median operative time was 205 minutes for the reoperative group and 200 for primary pyeloplasty (p = 0.98). Length of stay was longer in the reoperative group (p = 0.049), although no major complications were recorded in this group. All reoperative cases and 96% of primary pyeloplasty cases remained asymptomatic following surgery (p = 0.99). Postoperative improvement was similar for both groups on ultrasound (90% for reoperation vs 92% for primary pyeloplasty, p = 0.99) and renogram (80% vs 88%, p = 0.6). Conclusions: Laparoscopy seems to be safe and effective for management of failed pyeloplasty in children. Based on our data, reoperation is as safe and effective as primary pyeloplasty. References 1 : Meta-analysis of robot-assisted vs conventional laparoscopic and open pyeloplasty in children. BJU Int2014; 114: 582. 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Volume 197Issue 3 Part 1March 2017Page: 798-804 Advertisement Copyright & Permissions© 2017 by American Urological Association Education and Research, Inc.Keywordskidney pelvisreoperationureteral obstructionlaparoscopyurologic surgical proceduresMetricsAuthor Information Paulo Renato Marcelo Moscardi More articles by this author João Arthur Brunhara Alves Barbosa More articles by this author Hiury Silva Andrade More articles by this author Marcos Figueiredo Mello More articles by this author Bruno Nicolino Cezarino More articles by this author Lorena Marçalo Oliveira More articles by this author Miguel Srougi More articles by this author Francisco Tibor Dénes More articles by this author Roberto Iglesias Lopes More articles by this author Expand All Advertisement PDF downloadLoading ...