Abstract

Objectives: This study aims to compare the demographic characteristics, ultrasonographic findings, and functional outcomes of pediatric patients who underwent open or laparoscopic pyeloplasty in our clinic, thereby evaluating the effectiveness of both surgical techniques.

Patients and methods: Between June 2017 and September 2025 a total of 49 patients were enrolled and divided into two groups based on the surgical approach performed: Open surgery group (29 males, 4 females; mean age: 1.30 ± 3.25 years; range, 0 to 14 years) and laparoscopic surgery group; (9 males, 7 females; mean age: 5.81 ± 3.90 years; range, 1 to 12 years). Data from patients who underwent open or laparoscopic pyeloplasty for ureteropelvic junction obstruction were retrospectively reviewed. Patients were categorized into two groups according to the surgical approach. Age, sex, laterality, presence of urinary tract infection (UTI), pre- and postoperative hydronephrosis (HN) grade, anteroposterior pelvic diameter (APD), parenchymal thickness, and mercaptoacetyltriglycine (MAG3) scintigraphy findings were compared. Mann-Whitney U, chi-square, and Wilcoxon signed-rank tests were used for statistical analysis.

Results: Patients in the laparoscopic group were significantly older than those in the open group (p < 0.001). Sex distribution differed between groups, with a higher proportion of males in the open group (p < 0.05). No significant differences were observed regarding laterality of obstruction or the incidence of UTI. In the open pyeloplasty group, significant improvements in MAG3 drainage and differential renal function were observed when comparing preoperative and postoperative values (p < 0.05). In the laparoscopic group, statistical comparison was not feasible due to insufficient paired postoperative MAG3 data. Preoperative MAG3 renal function values were significantly lower in the laparoscopic group (p < 0.001). Preoperative HN grades were significantly higher in the open group (p < 0.05). Both groups demonstrated significant reductions in HN grades during postoperative follow-up. In early postoperative assessments, HN grades and APD were lower in the laparoscopic group. Postoperative APD was significantly smaller in the laparoscopic group (p < 0.05).

Conclusion: Both surgical approaches are effective in relieving obstruction and preserving renal function. Laparoscopic pyeloplasty offers advantages in terms of minimal invasiveness, early morphological improvement, and cosmetic outcomes, whereas open surgery remains a reliable option in patients with severe HN.

Citation: Yener S. Comparison of outcomes in pediatric patients undergoing open and laparoscopic pyeloplasty: A single-center retrospective study. Turkish J Ped Surg 2026;40(2):87-92. doi: 10.62114/JTAPS.2026.215.