Long-term outcome of retroperitoneoscopic one-trocar-assisted pyeloplasty: a single-center and single-surgeon experience

Quang Thanh Nguyen; Thuy Mai Nguyen; Dung Anh Le; Luan Vo Mac Nguyen; Trang Thu Dang; Son Hoang Nguyen; Vy Huynh Khanh Nguyen; Liem Thanh Nguyen

doi:10.1007/s11255-024-04091-9

Long-term outcome of retroperitoneoscopic one-trocar-assisted pyeloplasty: a single-center and single-surgeon experience

Int Urol Nephrol. 2024 May 27. doi: 10.1007/s11255-024-04091-9. Online ahead of print.

Authors

Quang Thanh Nguyen^{1

2}, Thuy Mai Nguyen¹, Dung Anh Le¹, Luan Vo Mac Nguyen², Trang Thu Dang², Son Hoang Nguyen², Vy Huynh Khanh Nguyen², Liem Thanh Nguyen³

Affiliations

¹ Department of Pediatric Surgery, The National Hospital of Pediatrics, Hanoi, Vietnam.
² College of Health Science, VinUniversity, Hanoi, Vietnam.
³ Vinmec Research Institute of Stem Cell and Gene Technology, Vinmec Health Care System, Vinmec Times City, Minh Khai, Hanoi, Vietnam. liemnhp@gmail.com.

PMID: 38797767
DOI: 10.1007/s11255-024-04091-9

Abstract

Purpose: The aim of this study was to assess the long-term outcomes of retroperitoneoscopic one-trocar-assisted pyeloplasty (OTAP) for ureteropelvic junction obstruction (UPJO) in children.

Methods: This retrospective analysis included 70 pediatric cases, all under the age of 5, diagnosed with UPJO and treated with the OTAP technique between May 2011 and June 2013 by a single surgeon. A single 10 mm operative scope with a 5 mm working channel was utilized to mobilize the ureteropelvic junction (UPJ) and exteriorize it through the trocar insertion site. Subsequently, conventional Anderson-Hynes dismembered pyeloplasty was conducted extracorporeally. Patient's demographics, operative time, hospital stay, complications, and success rate were evaluated.

Results: Seventy pediatric patients (65 males and 5 females) underwent OTAP, with ages at the time of operation ranging from 1 month to 5 years (mean = 22.6 ± 18.6 months). The mean operative time was 74.8 ± 15.2 min. There was a significant reduction in the mean renal pelvis size from 34.3 ± 8.1 mm preoperatively to 13.8 ± 4.7 mm postoperatively (p < 0.05). Moreover, the mean differential renal function (DRF) increased from 47.9 ± 9.8% preoperatively to 51.2 ± 5.9% postoperatively (p < 0.05). All patients experienced an uneventful postoperative recovery, with a median hospital stay of 3.4 days. The success rate was 95.7%, with a median follow-up time of 75 months (range: 6-125 months).

Conclusion: OTAP is a safe and feasible minimally invasive technique to correct ureteropelvic junction obstruction in children. It could be considered as a treatment of choice for children under the age of 5 as it combines the advantages of open and retroperitoneoscopic pyeloplasty and presents excellent long-term outcomes.

Trial registration number: NCT06349161 April 4th, 2024, retrospectively registered.

Keywords: Hydronephrosis; Laparoscopic; One trocar; Pyeloplasty; Retroperitoneoscopic; Ureteropelvic junction obstruction.

Associated data

ClinicalTrials.gov/NCT06349161