Laparoscopic management of ureteropelvic junction obstruction in pediatric patients: A new approach to crossing vessels, crossing vein division, and upward transposition of the crossing artery

Nasser Simforoosh, Ahmad Javaherforooshzadeh, Alireza Aminsharifi, Mohammad Hossein Soltani, Mohammad Hadi Radfar, Hossein Kilani

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Objective: To demonstrate the role of the laparoscopic approach for management of primary ureteropelvic junction obstruction (UPJO) using two different techniques in the pediatric age group. Material and methods: From April 2005 to October 2008, 63 pediatric patients underwent treatment of primary UPJO via a laparoscopic approach. Dismembered pyeloplasty was elected in 56 renal units while nine patients were managed by upward transposition of accessory renal artery after division of accessory renal vein. No JJ stent was required in these nine patients. Results: Mean age of patients was 61 (2-180) months. Mean operative time was significantly lower in those managed by transposition of aberrant vessels compared with dismembered pyeloplasty. The mean hospital stay was 6.4 (2-14) days for the dismembered technique and 2.1 (1-4) days for the vascular transposition approach. Significant improvement of obstruction was achieved in all of the patients who underwent the modified Hellstrom technique and in 92.81% of the renal units undergoing dismembered pyeloplasty. Conclusion: The technique of laparoscopic transposition of crossing renal artery without violating collecting system may have a role in minimally invasive management of UPJO in selected pediatric patients. Further research with larger samples and a longer follow-up period is required.

Original languageEnglish (US)
Pages (from-to)161-165
Number of pages5
JournalJournal of Pediatric Urology
Volume6
Issue number2
DOIs
StatePublished - Apr 2010

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Urology

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