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19–22 APRIL, 2017, BARCELONA, SPAIN
MATERIAL AND METHODS
Retrospective chart review of infants who underwent Anderson-Hynes pyeloplasty from 2004 to
2016 was performed. We defined two groups: open pyeloplasty (OP) and laparoscopic pyeloplasty
(LP). Demographic, clinical and surgical data were assessed.
RESULTS
73 patients (60 boys) were included. 70 presented uteropelvic junction stenosis and 3 crossing ves-
sels. 29 surgeries were laparoscopic. There was no difference between OP and LP in terms of age,
weigh, gender and side (p=0.90, p=0.54, p=0.91, p=0.191, respectively). Preoperative mean pelvis
and calices diameters were 29.5mm and 9.5mm in OP and 25.6mm and 9.55mm in LP (p=0.117,
p=0.957, respectively). We registered one conversion to open pyeloplasty. Mean differential renal
function was 47.4% in OP and 44.8% in LP (p=0.35). Mean operative time was 126 minutes in
OP and 145 in LP (p=0.017). Etiology and surgical approach weren’t related (p=1). We registered
2 urinary leakage in OP and 2 in LP (p=1), 1 patient in LP need reoperation. Mean hospital stay
was 6.3 days in OP and 3.7 in LP (p<0.001). Postoperative mean pelvis and calices diameters were
11mm and 4.9mm in OP and 8.7mm and 2.5mm in LP (p=0.43, p=0.039, respectively). Decrease of
pelvis and calices dilation was similar in both groups (p=0.61, p=0.114). There was one recurrence
in OP.
CONCLUSIONS
Starting from equivalent groups, laparoscopic procedure reaches comparable results, similar com-
plication rates with shorter hospital stay.
10:43–10:48
S15-5 (VP)
★
LAPAROSCOPIC RETROPERITONEAL APPROACH
FOR A RARE CASE OF MID URETERIC STENOSIS
ASSOCIATED TO UPJ OBSTRUCTION ON SINGLE KIDNEY
Alaa EL-GHONEIMI, Matthieu PYECELON, Liza ALI and Annabel PAYE-JAOUEN
Robert-Debré University Hospital, Assistance-Publique Hôpitaux de Paris; Université Paris Diderot, S, Paediatric
Urology, Paris, FRANCE
PURPOSE
Congenital midureteric stenosis is an uncommon cause of obstructive uropathy. In some exceptional
cases it may be associated with stenosis at uretero-pelvic junction (UPJ). In this rare association;
the challenge is to preserve the vascularization of the dilated ureteral segment between the two
stenosis. We describe a retroperitoneal laparoscopic approach for treating safely and simultane-
ously both stenosis in a single functioning kidney.
MATERIAL AND METHODS
Fourteen months old girl had left prenatal hydronephrosis. MAG3 and URO-MRI significant hy-
dronephrosis of a single functioning kidney, stenosis at the UPJ and on the mid ureter, suggesting
ureteral valves, and dilated lumbar ureter. Retrograde confirmed the diagnosis. The Child was
placed in a flank position and underwent three-ports laparoscopic retroperitoneal approach (optic
:5mm and 2 operating: 3mm). To preserve the vascularization of the dilated lumbar ureter, the proxi-
mal anastomosis was done side to side between the dilated renal pelvis and the dilated proximal
ureter. The distal anastomosis was done end to end (6/0 monofilament). Drainage: percutaneous
trans-anastomotic stent, peri-renal suction, and bladder catheter.