International urology and nephrology · 2026
Initial experience with combined laparoscopic pyeloplasty with adjunct flexible ureteroscopy for management of ureteropelvic junction obstruction with renal calyceal stones in children: a retrospective study.
СтатьяНазвание и аннотация: Перевод в очереди
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Lu Tengfei, Li Pin, Li Bojian, Ma Lifei, Tao Tian, Zhou Xiaoguang, Zhou Huixia, Liu Dehong
Аннотация
BACKGROUND: Selecting an appropriate procedure to simultaneously treat patients with concomitant ureteropelvic junction obstruction (UPJO) and renal stones in children remains a challenge. The aim of this retrospective study was to investigate the safety and feasibility of laparoscopy pyeloplasty with adjunct flexible ureteroscopy (FURS) for treating children with UPJO and renal calyceal stones.
METHODS: 38 children with UPJO and renal calyceal stones who underwent laparoscopy pyeloplasty with adjunct FURS between January 2013 and December 2022 at our institution were retrospectively reviewed. All the patients were preoperatively diagnosed and followed up based on clinical presentation, urine analysis, ultrasonography, intravenous pyelography, magnetic resonance urography, and diuretic renography using a Tc-99m mercaptoacetyltriglycine scan. Preoperative clinical data and outcomes were analyzed for the initial experience of laparoscopy pyeloplasty with adjunct FURS in children.
RESULTS: This study included 26 males and 12 females, with 17 patients having UPJO in the left kidney and 21 in the right kidney. The age range was from 3 to 10 years, with a mean age of 5.3 years. All procedures were successful without conversion to open surgery. The mean procedure time was 138.1 min (119-163 min), the mean time to drain removal was 2.3 ± 0.9 days (1 to 4 days), the mean time to commencement of oral feeding was 1.4 ± 0.5 days (1 to 2 days), and the mean duration of hospitalization was 7.5 ± 1.8 days (6 to 11 days). Ultrasonography and magnetic resonance urography revealed that, for all patients, the renal pelvis anteroposterior diameter regressed, the thickness of the renal parenchyma increased, and no residual fragments were observed. Diuretic renograms showed T1/2 < 20 min for all patients, and no obstructions were observed.
CONCLUSION: Laparoscopy pyeloplasty with adjunct FURS is feasible and safe for the treatment of pediatric patients with UPJO and renal calyceal stones.
METHODS: 38 children with UPJO and renal calyceal stones who underwent laparoscopy pyeloplasty with adjunct FURS between January 2013 and December 2022 at our institution were retrospectively reviewed. All the patients were preoperatively diagnosed and followed up based on clinical presentation, urine analysis, ultrasonography, intravenous pyelography, magnetic resonance urography, and diuretic renography using a Tc-99m mercaptoacetyltriglycine scan. Preoperative clinical data and outcomes were analyzed for the initial experience of laparoscopy pyeloplasty with adjunct FURS in children.
RESULTS: This study included 26 males and 12 females, with 17 patients having UPJO in the left kidney and 21 in the right kidney. The age range was from 3 to 10 years, with a mean age of 5.3 years. All procedures were successful without conversion to open surgery. The mean procedure time was 138.1 min (119-163 min), the mean time to drain removal was 2.3 ± 0.9 days (1 to 4 days), the mean time to commencement of oral feeding was 1.4 ± 0.5 days (1 to 2 days), and the mean duration of hospitalization was 7.5 ± 1.8 days (6 to 11 days). Ultrasonography and magnetic resonance urography revealed that, for all patients, the renal pelvis anteroposterior diameter regressed, the thickness of the renal parenchyma increased, and no residual fragments were observed. Diuretic renograms showed T1/2 < 20 min for all patients, and no obstructions were observed.
CONCLUSION: Laparoscopy pyeloplasty with adjunct FURS is feasible and safe for the treatment of pediatric patients with UPJO and renal calyceal stones.