Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Urology

Objective: Laparoscopic pyeloplasty has become a viable option for the treatment of patients with ureteropelvic junction (UPJ) obstruction. We report on the safety and efficacy of this technique by reviewing the results of laparoscopic pyeloplasty in infants and children in 2 centers. We evaluated the rate and type of complications, as well as using subjective and objective measures for the improvement of UPJ obstruction.Results: Mean operative time was 226 minutes and the average postoperative hospital stay was 1.7 days. We had no major intraoperative complications. We had mild post-operative complications in the form of transient fever or hematuria, and port site infection in 5 patients, persistent drainage in 5 (which stopped spontaneously in 2 to 6 days), and ileus for 3 to 6 days in 6 children. On follow up, success was achieved in 96.4% of all cases, or 96.9% of cases completed laparoscopically. Improvement in renal scan parameters was observed in 88.9% of the 45 patients who had follow up renograms. Success rate was 93% among the 41 infants under 12 moths of age that we had. Conclusion: Laparoscopic pyeloplasty is effective and safe in infants and young children with UPJ obstruction, providing good outcome with minimal complications, a reasonable operative time and short hospital stay

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