Hybrid procedure for pyeloplasty in infants and young children with ureteropelvic junction obstruction is a safe and effective alternative

SummaryBackgroundUreteropelvic junction obstruction (UPJO) is a common congenital urinary tract anomaly causing hydronephrosis in children. Laparoscopic pyeloplasty has become a popular and effective method to treat UPJO both in children and adults, but seems controversial in neonates or infants.Materials and methodsFrom January 2007 to May 2012, patients with UPJO aged <18 years undergoing operations at our institute were included in this study. By retrospectively reviewing medical charts, the demographic data, presentation, laterality, etiology, operative time, length of hospital stay, stents, drainage tubes, and postoperative complications were recorded. Surgical outcomes were evaluated based on renal sonography and Lasix diuretic renography.ResultsA total of 47 patients (40 boys and 7 girls) were enrolled initially, but seven patients who were complicated with other congenital anomalies of the urinary system or who underwent surgery at other hospitals were excluded. Among these 40 patients, 21 had open pyeloplasty (Group I), eight who were younger than 1 year old or weighed <10 kg had a hybrid procedure (Group II), and 19 had laparoscopic surgery (Group III). The mean age was younger in Groups I and II because the selected procedure was nonrandomized. The operative time and the duration of perianastomotic drainage were longer in Groups II and III. There was no significant difference with regard to successful resolution of UPJO among the three groups.ConclusionIn infants or young children (<1 year old or weighing <10 kg) with UPJO, the hybrid procedure of pyeloplasty may be considered as a safe, effective, and less time-consuming alternative to laparoscopic surgery, and most importantly, confirms the security of the anastomosis.