Comparison of retroperitoneal and single-Site transperitoneal laparoscopic Anderson-Hynes dismembered pyeloplasty for the treatment of hydronephrosis in children
Xie huawei1, Zhou Huixia1, Ma Lifei1, Zhou Xiaoguang1, Shen Zhou1, Tao Tian1, Ma Sichao1, Zhang Xu2
1Department of Urology, Bayi Children's Hospital Affiliated To Beijing Military Region General Hospital,Beijing, 100007,China; 2Department of Urology, Chinese PLA General Hospital
Abstract：Objective:To compare the clinical effectiveness and safety of retroperitoneal and transperitoneal laparoscopic Anderson-Hynes dismembered pyeloplasty for the treatment of hydronephrosis(UPJO) in children.Methods:155 children with hydronephrosis between October 2009 and October 2011 were collected to clinical research, retroperitoneal laparoscopic Anderson-Hynes dismembered pyeloplasty was applied in 75 cases(Group A), and the transperitoneal approach was applied in 80 cases(Group B). The operative time, intraoperative blood loss, duration of the urethral catheter time, the postoperative hospital stay and the postoperative result were compared between the 2 groups.Results:All operations were successful without conversion to open surgery. There are no significant differences in the intraoperative blood loss, duration of the urethral catheter time, the postoperative hospital stay and the postoperative result between two groups. However group A has slightly longer operative time and shorter duration of the urethral catheter time. Group B injuried duodenum in one case, and group A did not appear.Conclusions:Retroperitoneal and single-port transperitoneal laparoscopic pyeloplasty in treatment of hydronephrosis in children were safe and feasible, but transperitoneal laparoscopic pyeloplasty has more operating space and better cosmetic effect.
[1]Gallo F, Schenone M, Giberti C. Ureteropelvic junction obstruction: which is the best treatment today? J Laparoendosc Adv Surg Tech A, 2009,19(5):657-662.
[2]Moon DA, El-Shazly MA, Chang CM, et al. Laparoscopic pyeloplasty: evolution of a new gold standard. Urology, 2006,67(5):932-936. [3]Zhou HX, Li HZ, Zhang X, et al. Retroperitoneoscopic Anderson-Hynes dismembered pyeloplasty in infants and children: a 60-case report. Pediatr Surg Int,2009,25(6):519-523. [4]谢华伟,周辉霞,马立飞,等.腹腔镜肾盂成形术治疗新生儿重度肾积水. 中华实用儿科临床杂志,2013,28(5):387-389. [5]黄澄如.实用小儿泌尿外科学.北京:人民卫生出版社,2006. [6]White WM, Haber GP, Goel RK, et al. Single-port urological surgery: single-center experience with the first 100 cases. Urology, 2009,74(4):801-804. [7]Tugcu V, Ilbey YO, Polat H, et al. Early experience with laparoendoscopic single-site pyeloplasty in children. J Pediatr Urol, 2011,7(2):187-191. [8]Zhou H, Sun N, Zhang X, et al. Transumbilical laparoendoscopic single-site pyeloplasty in infants and children: initial experience and short-term outcome. Pediatr Surg Int, 2012,28(3):321-325. [9]毕允力,阮双岁,陆良生,等.单切口腹腔镜肾盂成形术治疗小儿肾盂输尿管连接部梗阻. 中华小儿外科杂志,2011,32(1):33-36. [10]Sivaraman A, Leveillee RJ, Patel MB, et al. Robot-assisted laparoscopic dismembered pyeloplasty for ureteropelvic junction obstruction: a multi-institutional experience.Urology,2012,79(2):351-355. [11]黄格元,蓝传亮,刘雪来,等.达芬奇机器人在小儿外科手术中的应用(附20例报告).中国微创外科杂志,2013, 13(1):4-8. [12]Tan HL. Laparoscopic Anderson-Hynes dismembered pyeloplasty in children. J Urol, 1999,162(3 Pt 2):1045-1048. [13]Grignon A, Filion R, Filiatrault D, et al. Urinary tract dilatation in utero: classification and clinical applications. Radiology, 1986,160(3):645-647. [14]周辉霞,孙宁,马立飞,等.腹腔镜下重复肾半肾切除手术路径的探讨.临床小儿外科杂志,2011,10(1):24-27.
