An advantageous practical modification in mini-laparoscopic pyeloplasty for prepubertal children: Extracorporeal ureteral spatulation, suturing and stenting – EUSSS technique


Sezer A., Turedi B., Bulbul E.

BMC Urology, cilt.24, sa.1, 2024 (SCI-Expanded, Scopus) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 24 Sayı: 1
  • Basım Tarihi: 2024
  • Doi Numarası: 10.1186/s12894-024-01645-y
  • Dergi Adı: BMC Urology
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, Directory of Open Access Journals
  • Anahtar Kelimeler: Extracorporeal, Laparoscopy, Pediatric, Pyeloplasty, Ureteropelvic junction obstruction
  • İstanbul Üniversitesi-Cerrahpaşa Adresli: Hayır

Özet

Background: Ureteral spatulation, the first ureteral suture, and double-J stenting may be challenging and time-consuming in laparoscopic pyeloplasty, especially in small children. We aimed to present our comparative results of the extracorporeal ureteral spatulation, suturing, and stenting (EUSSS) technique in mini-laparoscopic pyeloplasty (MLP) and the conventional intracorporeal technique in prepubertal children. Methods: The data of 46 prepubertal pediatric patients (< 12 years) who underwent laparoscopic pyeloplasty by a single surgeon between January 2021 and October 2023 were retrospectively reviewed. The patients were divided into two groups: who underwent EUSSS-MLP (Group-1, n = 26) and who underwent conventional intracorporeal pyeloplasty (Group-2, n = 20). Results: The mean age of all patients was 5.3 years (4.8 ± 2.8 years in Group-1 and 6.0 ± 2.1 years in Group-2 p = 0.126). The mean duration of ureteral preparation plus double-J stenting was 5.7 ± 1.6 min in Group-1 and 19.2 ± 4.1 min in Group-2 (p < 0.0001). The mean duration of surgery was statistically significantly higher in Group-2 (p = 0.034). There was no significant difference in terms of postoperative complications (p = 0.482). Laparoscopic pyeloplasty was successful in 42 (91.3%) patients, with no statistically significant difference between the two groups (Group-1: 24 (92.3%), Group-2:18 (90%), p = 0.783). Conclusion: Extracorporeal ureteral preparation and double-J stenting can be safely and effectively preferred in MLP for prepubertal children.