Original Articles
Laparoscopic Transperitoneal Pyeloplasty Forureteropelvic Junction Obstruction in Paediatric population | |
Dr. Zaffer Saleem Khanday, Dr. Adil Ahmad, Dr. Mufti Mahmood Ahmed, Dr. Syed Javaid Qadri, Dr. Manzoor Ahmad Chalkoo, Dr. Arshad Iqbal | |
Background: The Ureteropelvic Junction Obstruction (UPJO) is one of the most prevalent genitourinaryabnormalities in children.(UPJO) is considered as the most common cause of congenital hydronephrosis. Pyeloplasty is the main treatment method for patients with (UPJO) [5]. An ideal treatment should have the highest success rate and be minimally invasive. There are many techniques for (UPJO) repair, but the Dismembered Anderson Hynes pyeloplasty remains the goldst and ard for surgicalreconstruction[8].Laparoscopic Anderson-Hynes pyeloplasty has becomethegoldst and ardinmanypediatric centers. Objectives: To Assess the Safety and Efficacy of laparoscopic Trans Peritoneal Pyeloplasty in Children with(UPJO). Methods: The study included 30 consecutive cases of congenital unilateral (UPJO) with Split Renal Function (SRF)<40% managed during the 24-month period from November 2020 to November 2022. All the patients were properly evaluated before proceeding for procedure. Results: In our study the mean age of patients was 6.4 years. Most of the children affected were males(76.7%) and involvement of Left (UPJO). The commonest cause of pelvi-ureteric junction obstruction was an abnormal proximal segment (53.3%) followed by crossing vessel (20%).The pre-op Antero posterior Pelvic Diameter (APPD) on ultrasonography was in range from 21mm to 50mm, with a mean pre op APPD of 36.26mm.Most of the patients (83%) had a pre-operative differential renal function in the range of 31-40 %( 34.8%).Mean operative time was 99.06mins. Mean post op APPD was 27.38mmand DRF was 40.72%. 96% of the patients had an indwelling catheter in situ for a period of less than one week. Out of total 30 patientsanastomoticdrainwaskeptfor3 weeksin28patients(83.34%).Mean hospital stay in days was7.53days. Conclusion: Laparoscopic Trans PeritonealPyeloplastyisasafeandeffective,minimallyinvasiveprocedure in pediatric patients with (UPJO), characterized by good surgical efficiency, reduced complications, and fasterreco very and satisfactory followup results. |
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