Abstract

Objective: In ureteropelvic junction obstruction, regardless of the procedure, pyeloplasty with or without pelvic reduction is the gold standard treatment method. Pyeloplasty can be performed using open, laparoscopic and robotic surgical methods. Our surgical results were evaluated in patients operated with anterolateral mini lumbotomy incision.

Method: Between April 2004-2019, 97 children under one year of age whose pyeloplasties were performed through anterolateral mini lumbotomy incisions among 153 patients who were operated due to ureteropelvic junction obstruction in our clinic were included in the study. The records of the patients were evaluated and analyzed in terms of duration of the operation, need for enlargement of the incision, drainage and double-J/ pyelostomy catheter usage, postoperative length of stay, complications and its outcomes.

Results: Sixteen (16%) female and 81 (84%) male patients (total n, 97) were operated in the Pediatric Surgery Clinic within 15 years. The median ages at surgery were 18 days (7 days-28 days) in newborns, and 4.2 months in infants (29 days-11,9 months). Twenty-three patients (24%) had right, 65 (67%) had left and 9 (9%) had bilateral ureteropelvic junction obstruction. Anderson-Hynes pyeloplasty was performed through 2.5-3 cm anterolateral mini lumbotomy incisions in a total of 106 kidney units. In almost all cases, ureteropelvic anastomosis was completed with 6/0 or 7/0 PDS sutures in a watertight manner after pelvic reduction. The mean operative time was 88 minutes (60 min-120 min). The patients were fed at the postoperative fourth hour. The drains of the patients (if present) were removed on the postoperative second day and the patients were discharged on the same or third postoperative day. The pyelostomy catheters used in 8 kidneys (8%) were removed after an average of 10 days (7-15 days), and the double-J catheters used in 92 kidneys (87%) were removed by cystoscopy after an average of 5 weeks (4-6 weeks), and 80 male infants were also circumcised.

Conclusion: In ureteropelvic junction obstruction surgery, pyeloplasty with anterolateral mini lumbotomy incision which is an open minimally invasive surgical method is applicable and successful due to short operation time, low complication rates, good cosmetic results and short hospitalization period.

Atıf vermek için: Cansaran S, Celayir A, Moralıoğlu S. Üreteropelvik bileşke obstrüksiyonunda açık minimal invaziv cerrahi: Anterolateral mini lombotomi insizyonu ile ekstraperitoneal yaklaşım. Çoc. Cer. Derg. 2019;33(3):118-25.