Document Detail


Comparison of flank, dorsal lumbotomy and laparoscopic approaches for dismembered pyeloplasty in children older than 3 years with ureteropelvic junction obstruction.
MedLine Citation:
PMID:  19914659     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Selecting a surgical approach for correction of ureteropelvic junction obstruction in children is mostly driven by surgeon preference, and includes laparoscopy, flank incision and dorsal lumbotomy. Comparative analyses focusing on operative time, hospital stay and complications are lacking. MATERIALS AND METHODS: We retrospectively reviewed the charts of 41 consecutive patients older than 3 years who underwent laparoscopic pyeloplasty by a single surgeon between 2005 and 2008. We compared these cases to 67 age matched cases managed by flank incision (42) or dorsal lumbotomy (25). We evaluated age at surgery, operative time, performance of retrograde pyelogram, length of hospitalization and complication/failure rates. RESULTS: Mean patient age was 7.3 to 8.1 years. Mean operative time was significantly longer for laparoscopy (178 minutes) compared to flank incision (144) and dorsal lumbotomy (148, p = 0.01). Mean hospital stay was significantly shorter for laparoscopy (2.3 days) compared to flank incision (3.6) and dorsal lumbotomy (3.3, p = 0.01). Complications occurred in 4 laparoscopic, 2 flank incision and 2 dorsal lumbotomy procedures. Patients who underwent laparoscopic pyeloplasty had a significantly shorter mean followup (28 months) compared to flank incision (49) and dorsal lumbotomy (47, p = 0.02). CONCLUSIONS: Overall complication rates were not significantly different for the 3 pyeloplasty approaches. For the evaluated outcomes our data do not favor one particular surgical access over others in children older than 3 years.
Authors:
Luis H P Braga; Armando J Lorenzo; Darius J Bägli; Mohamed Mahdi; Joao L Pippi Salle; Antoine E Khoury; Walid A Farhat
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of urology     Volume:  183     ISSN:  1527-3792     ISO Abbreviation:  J. Urol.     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2009-12-16     Completed Date:  2010-01-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  306-11     Citation Subset:  AIM; IM    
Affiliation:
Division of Urology, McMaster Children's Hospital, McMaster University, Hamilton, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Child
Child, Preschool
Female
Humans
Kidney Pelvis / surgery*
Laparoscopy / methods*
Length of Stay
Male
Postoperative Complications / epidemiology
Retrospective Studies
Ureteral Obstruction / surgery*
Urologic Surgical Procedures / methods

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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