Laparoscopic pyeloplasty found safe, efficacious in infants

Ureteropelvic junction (UPJ) obstruction in young children can be successfully repaired with transperitoneal laparoscopic pyeloplasty, say researchers from Children’s Hospital of Pittsburgh of University of Pittsburgh Medical Center.

Transperitoneal laparoscopic pyeloplasty has emerged as a safe, effective alternative to the standard open procedure for the treatment of UPJ obstruction. Both laparoscopic and open pyeloplasty have comparable effectiveness in pediatric patients, but the role of the laparoscopic procedure in infants is less well defined.

"This population can be challenging to treat laparoscopically because of the small size of the abdomen and caliber of the ureter," said senior author Michael Ost, MD.

For the study, which was published in the Journal of Urology (2013; 189:1503-7), Dr. Ost and colleagues reviewed records of 29 children younger than 12 months of age treated with transperitoneal laparoscopic pyeloplasty for UPJ obstruction from May 2005 to February 2012. Of the 24 patients for whom follow-up data were available, 22 (92%) had successful repairs. Two patients required a second, open procedure to correct the obstruction.

"Our results show the laparoscopic approach is a safe and effective option for the surgical management of UPJ obstruction in the infant population," said Dr. Ost. "Our early experience reveals a developing success rate comparable to that of other treatment modalities with minimal morbidity."

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