Latitudes and attitudes: A multinational study of laparoscopic pyeloplasty in children.

Autor: Echeverria P; Hospital Exequiel González Cortés, Santiago, Chile., Reed L F; Hospital Exequiel González Cortés & Clínica Alemana, Santiago, Chile., Gatti JM; Children´s Mercy Hospital, Kansa City, Missouri, USA., Braga LH; McMaster University, Hamilton, Canada., Cherian A; Great Ormond Street Hospital, London, England, UK., Garcia-Aparicio L; Hospital Saint Joan de Deu, Barcelona, Spain., Metcalfe P; Stollery Children´s Hospital, Alberta, Canada., Ruiz J; Hospital Prof. Dr. J.P. Garrahan, Buenos Aires, Argentina., Bortagaray JI; Monash Hospital, Melbourne, Australia., Martin-Sole O; Hospital Saint Joan de Deu, Barcelona, Spain., Leclair MD; Hôpital Mère-Enfant Chirurgie Infantile, Nantes, France., Bujons A; Fundación Puigvert, Barcelona, Spain., de Badiola F; Hospital Italiano, Buenos Aires, Argentina., Coleman R; Monash Hospital, Melbourne, Australia., Webb NR; Monash Hospital, Melbourne, Australia., Corbetta JP; Hospital Prof. Dr. J.P. Garrahan, Buenos Aires, Argentina., Moldes JM; Hospital Italiano, Buenos Aires, Argentina., Mushtaq I; Great Ormond Street Hospital, London, England, UK., Lopez PJ; Hospital Exequiel González Cortés & Clínica Alemana, Santiago, Chile; Servicio Pediatria y Cirugia Infantil, Facultad Medicina, Universidad de, Chile. Electronic address: pejotalopez@gmail.com.
Jazyk: angličtina
Zdroj: Journal of pediatric urology [J Pediatr Urol] 2023 Feb; Vol. 19 (1), pp. 86.e1-86.e6. Date of Electronic Publication: 2022 Oct 08.
DOI: 10.1016/j.jpurol.2022.10.005
Abstrakt: Purpose: The Anderson-Hynes technique has been the treatment of choice for primary ureteropelvic junction obstruction in children. Laparoscopic approach has shown similar outcomes to open, with advantages of shorter hospital stay and less pain. We reviewed the experience of 11 geographically diverse, tertiary pediatric urology institutions focusing on the outcomes and complications of laparoscopic pyeloplasty.
Materials and Methods: A descriptive, retrospective study was conducted evaluating patients undergoing Anderson-Hynes dismembered laparoscopic pyeloplasty. Centers from four different continents participated. Demographic data, perioperative management, results, and complications are described.
Results: Over a 9-year period, 744 laparoscopic pyeloplasties were performed in 743 patients. Mean follow-up was 31 months (6-120m). Mean age at surgery was 82 months (1 w-19 y). Median operative time was 177 min. An internal stent was placed in 648 patients (87%). A catheter was placed for bladder drainage in 702 patients (94%). Conversion to open pyeloplasty was necessary in seven patients. Average length of hospital stay was 2.8 days. Mean time of analgesic requirement was 3.2 days. Complications, according to Clavien-Dindo classification, were observed in 56 patients (7.5%); 10 (1%) were Clavien-Dindo IIIb. Treatment failure occurred in 35 cases with 30 requiring redo pyeloplasty (4%) and 5 cases requiring nephrectomy (0.6%).
Conclusion: We have described the laparoscopic pyeloplasty experience of institutions with diverse cultural and economic backgrounds. They had very similar outcomes, in agreement with previously published data. Based on these findings, we conclude that laparoscopic pyeloplasty is safe and successful in diverse geographics areas of the world.
Competing Interests: Conflicts of interest None.
(Copyright © 2022 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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