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ORIGINAL ARTICLE
Evaluation of Open vs Laparoscopic Pyeloplasty in Children:

An Institutional Experience

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Vedamurthy Reddy Pogula, Ershad Hussain Galeti, Karthikesh Omkaram, Mallikarjuna Reddy Nalubolu 4
AbstrAct
Background: An ureteropelvic junction (UPJ) obstruction is a blockage of urine passage from the renal pelvis to the upper ureter. Back pressure
inside the renal pelvis can cause renal damage and function deterioration. In children, the adynamic segment, crossing vessel, ureteral valves, and
sticky bands are the most common causes of UPJ obstruction. The surgical rebuilding of the UPJ to drain and decompress the kidney is known
as pyeloplasty. The process, benefits, limits, and post-operative results of open and laparoscopic pyeloplasty are examined in this research.
Materials and methods: The study included children diagnosed with pelviureteric junction obstruction in the Urology Department at our
institute between January 2016 and December 2019. Ultrasound, micturating cystourethrogram, and diethylenetriamine pentaacetate (DTPA)
were used to evaluate them.
Results: Around 45 of the 70 instances involved boys. Twenty-one were discovered prenatally and confirmed postnatally using ultrasonography.
The most prevalent kind of presentation was abdominal mass in 44 (42.8%) of the youngsters. There were 35 open and 35 laparoscopic
pyeloplasties performed. The laparoscopic pyeloplasty group had a mean total operating time of 99.2 minutes with stent implantation, compared
to 80.5 minutes in the open group. The mean glomerular filtration rate (GFR) and differential renal function improved in both groups; however,
the difference was not statistically significant (p >0.05). The postoperative analgesic need was much reduced in the laparoscopic group as
compared to open pyeloplasty.
Conclusion: The major drawback of laparoscopic pyeloplasty is the length of time it takes to complete the procedure. It necessitates exceptional
intracorporeal suturing skills, and the benefit is that it has a lower rate of morbidity, shorter hospital stays, and better aesthetic results than
the open technique.
Keywords: Laparoscopy, Open surgery, Pyeloplasty.
World Journal of Laparoscopic Surgery (2021): 10.5005/jp-journals-10033-1483

IntroductIon 1–3 Department of Urology, Narayana Medical College, Nellore, Andhra
Urine flow blockage from the renal pelvis to the upper ureter is Pradesh, India
referred to as ureteropelvic junction (UPJ) obstruction. Back strain 4 Citizens Hospital, Nallagandla, Hyderabad, Telangana, India
inside the renal pelvis can cause renal damage and degeneration. A Corresponding Author: Ershad Hussain Galeti, Department of Urology,
primary obstructive lesion in the UPJ is most frequent in youngsters, Narayana Medical College, Nellore, Andhra Pradesh, India, Phone: +91
although it can occur in adults and the elderly as well. Adynamic 8074847997, e-mail: dr.ershadhussain@gmail.com
segment, crossing vessel, ureteral valves, and sticky bands are all How to cite this article: Pogula VR, Galeti EH, Omkaram K, et al.
etiologies causing UPJ blockage in youngsters. Pyeloplasty is the Evaluation of Open vs Laparoscopic Pyeloplasty in Children: An
surgical reconstruction of the UPJ to drain and decompress the Institutional Experience. World J Lap Surg 2021;14(3):173–176.
kidney. If remaining renal function is acceptable, it is most usually Ethics approval: Approved by the Institutional Ethical Committee.
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used to treat a UPJ blockage. The usual surgical therapy for UPJ Source of support: Nil
blockage is dismembered Anderson-Hynes pyeloplasty. This renal
pelvis surgery relieves the obstruction by completely eradicating the Conflict of interest: None
stenotic adynamic section of the UPJ and creating a larger conduit
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from the remaining ureter and renal pelvis tissue. The techniques,
advantages, and postoperative results of open pyeloplasty versus between January 2016 and December 2019. An ultrasound
laparoscopic pyeloplasty are compared in this study. of abdomen, micturating cystourethrogram, and DTPA study
were used to assess them. This research is both prospective
AIms And objectIves and retrospective. The research included 70 children with PUJ
obstruction, 15 of whom were female and 45 of whom were
The purpose of this study was to compare the procedures used male. The children’s symptoms and signs were assessed. Renal
in open and laparoscopic pyeloplasty, as well as the advantages function tests, ultrasonography of abdomen, micturating
and disadvantages of each treatment. The goal of this study was cystourethrogram, and DTPA were used to accomplish this.
to compare the outcomes of open and laparoscopic pyeloplasty.
The patients were randomized to either open or laparoscopic
pyeloplasty. They were assessed for renal function, postoperative
mAterIAls And methods pain, and hospital stay both before and after surgery. The inclusion
The study included children diagnosed with pelvic–ureteric criteria are met by all patients with PUJ obstruction. Cases with
junction (PUJ) blockage at our institute’s Urology Department concomitant reflux and recurring cases are exclusion criteria. A

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