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Purpose <p>To determine whether laparoscopic non-reduction pyeloplasty (NRP) in those with uretero-pelvic junction obstruction (UPJO) and large renal pelvis would lead to higher recurrence.</p> Methods <p>All patients who underwent laparoscopic NRP for UPJO between 2021 and 2023 were included. Patients were analyzed based on antero-posterior renal pelvic diameter (APD): group 1 ≥ 40&#xa0;mm and group 2 &lt; 40&#xa0;mm. Post-operative improvement in APD (%) and split renal function (SRF) at follow-up was compared with pre-operative values.</p> Results <p>75 patients (group 1: 19, group 2: 56) underwent laparoscopic NRP<b>.</b> No significant differences were found in age, laterality, surgery duration, or immediate post-operative complications. The mean APD in group 1 improved from 48.1&#xa0;mm preop to 31.1 at 6&#xa0;months (<i>p</i> = 0.001) and to 20.4 at 1&#xa0;year (<i>p</i> = 0.001). The mean APD in group 2 improved from 27.1&#xa0;mm preop to 15.9 at 6&#xa0;months (<i>p</i> = 0.001) and to 11.1 at 1&#xa0;year (<i>p</i> = 0.001). The SRF improved in the majority while few remained static. There was no significant difference in recurrence rate (1/19 vs 2/56; <i>p</i> = 1.00).</p> Conclusions <p>Laparoscopic NRP is safe in UPJO with large renal pelvis (APD &gt; 40&#xa0;mm). Further, larger studies are warranted to support or negate this finding.</p>

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Outcomes of not reducing large renal pelvis during laparoscopic pyeloplasty in children

  • 期刊论文

  • 发表日期：

    2025年2月20日

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  • Tharanendran Heera,
  • Dharmalingam Arun Prasad,
  • Ramesh Babu

摘要

Purpose

To determine whether laparoscopic non-reduction pyeloplasty (NRP) in those with uretero-pelvic junction obstruction (UPJO) and large renal pelvis would lead to higher recurrence.

Methods

All patients who underwent laparoscopic NRP for UPJO between 2021 and 2023 were included. Patients were analyzed based on antero-posterior renal pelvic diameter (APD): group 1 ≥ 40 mm and group 2 < 40 mm. Post-operative improvement in APD (%) and split renal function (SRF) at follow-up was compared with pre-operative values.

Results

75 patients (group 1: 19, group 2: 56) underwent laparoscopic NRP. No significant differences were found in age, laterality, surgery duration, or immediate post-operative complications. The mean APD in group 1 improved from 48.1 mm preop to 31.1 at 6 months (p = 0.001) and to 20.4 at 1 year (p = 0.001). The mean APD in group 2 improved from 27.1 mm preop to 15.9 at 6 months (p = 0.001) and to 11.1 at 1 year (p = 0.001). The SRF improved in the majority while few remained static. There was no significant difference in recurrence rate (1/19 vs 2/56; p = 1.00).

Conclusions

Laparoscopic NRP is safe in UPJO with large renal pelvis (APD > 40 mm). Further, larger studies are warranted to support or negate this finding.