Lumboscopic-assisted pyeloplasty: A single-port, retroperitoneoscopic approach for children with pelvi-ureteric junction obstruction
| Autor: | Dalim Kumar Baidya, Prabudh Goel, Vikram Khanna, Kashish Khanna, Minu Bajpai |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Pyeloplasty medicine.medical_treatment single-port pyeloplasty 030232 urology & nephrology lcsh:Surgery Anastomosis Extracorporeal retroperitoneoscopic 03 medical and health sciences 0302 clinical medicine hydronephrosis 030225 pediatrics medicine pelvi-ureteric junction obstruction Laparoscopy Hydronephrosis medicine.diagnostic_test business.industry lcsh:RJ1-570 Cosmesis Stent lcsh:Pediatrics lcsh:RD1-811 lumboscopic assisted medicine.disease Surgery medicine.anatomical_structure Pediatrics Perinatology and Child Health Original Article business Renal pelvis |
| Zdroj: | Journal of Indian Association of Pediatric Surgeons, Vol 25, Iss 3, Pp 163-168 (2020) Journal of Indian Association of Pediatric Surgeons |
| ISSN: | 1998-3891 0971-9261 |
| Popis: | Introduction: Pelvi-ureteric junction obstruction (PUJO) is one of the most common conditions presenting to a pediatric urologist. As laparoscopic or robotic-assisted pyeloplasty, either transperitoneal or retroperitoneal, involves intracorporeal suturing skills and has a long learning curve, they have not gained popularity among beginners in laparoscopy. Objective: We conducted a study to assess the results of a single-port, retroperitoneoscopic approach to renal access, i.e. lumboscopic-assisted pyeloplasty (LAP), by single surgeon at our institute. Materials and Methods: A retrospective review of all children who underwent LAP from July 2013 to March 2018 was conducted. Patients who presented with PUJO and required surgical treatment were included. A single-port lumboscopy using coaxial telescope was performed in prone position in all patients. The renal pelvis was dissected and retrieved through the port site followed by extracorporeal hand-sewn pyeloplasty over a double–J stent or a nephrostent. The operative time, postoperative pain, surgical complications, duration of hospital stay, follow-up, and cosmesis at 6 months postsurgery were evaluated. Results: A total of 96 children were included (72 males and 24 females), with the age at operation ranging from 3 months to 10 years (mean = 4.9 years). All patients had an uneventful postoperative recovery. Two patients had a superficial wound infection, and one patient was converted to open approach due to excessive bleeding. The average operating time was 80 ± 22.5 min, the median duration of hospital stay was 3 days, and the average scar length at 3 months was 15.6 ± 0.4 mm. Follow-up renogram (diethylenetriamine pentaacetic acid) showed satisfactory postpyeloplasty drainage pattern in 93 children while three showed obstructive drainage curves. Conclusion: LAP can be performed safely with minimal retroperitoneal dissection, excellent cosmetic results, and minimal postoperative pain in children with PUJO. It has a shorter learning curve as compared to laparoscopic pyeloplasty as it involves time tested extracorporeal hand-sewn anastomosis. |
| Databáze: | OpenAIRE |
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