Features of drainage of pyelocaliceal system in children after laparoscopic pyeloplasty

The study was aimed to improvement of results of treatment of children with congenital hydronephrosis due to reduction of invasiveness of operative approach and optimization of method of urine derivation in the postoperative period. From February 2008 to February 2012, 30 laparoscopic pyeloplasty were performed (16 boys, 14 girls, age from 2 months to 14 years, body weight 5500 g and more). Transabdominal pyeloplasty was performed by the Hynes-Anderson method. In 13 cases the ureteral stent deployment was performed, in 8 - pyelostoma was performed, nephrostomy performed earlier was maintained in 2 children, and in 7 children nephrostomy was performed by the proposed method. The mean duration of surgery was 110 (80-240) min. Results were followed for 3 to 53 months. 1 child on the 2nd day had falling pielostomy with the development of pyelonephritis, and 1 child had formation of urinoma. Both children had consistent anastomosis not required re-pyeloplasty. One child had persistent anastomotic stricture, which required re-pyeloplasty. Follow-up examinations included the ultrasound and intravenous urography. At the present moment, there are no complaints at all children, exacerbations of infections of the urinary system are not registered. Thus, laparoscopic pyeloplasty is an effective technique regardless of the age of the children, but it is necessary to further improve the drainage of the pelvicalyceal system in the postoperative period.

pediatrics, hydronephrosis, laparoscopy, pyeloplasty, drainage, ureteral stent, pyelostoma, nephrostoma