Abstract
Introduction Ureteropelvic junction obstruction (UPJO) is the most common pediatric obstructive
uropathy. We report our 8-year experience with the use of a retroperitoneal laparoscopic-assisted
pyeloplasty (one–trocar–assisted pyeloplasty [OTAP]).
Materials and Methods This is a retrospective analysis of 88 patients treated in 8 years. Surgery was performed
on the basis of standard indications and it consisted of 88 OTAP (the ureteropelvic
junction is identified through a retroperitoneoscopic inspection and it is exteriorized
to perform a traditional dismembered pyeloplasty). Operative time, hospital stay,
complication, success of the technique, and aesthetical results are analyzed.
Results In the 8-year period we performed 88 OTAP. Mean age was 19 months. Prenatal diagnosis
was the most common presentation (n = 73), followed by occasional identification (n = 8), and symptomatic (n = 7). Mean operating time was 139 minutes (range 60–225 minutes). Conversion was
required in seven cases. The success rate was 87.5% (reduction of the severity of
hydronephrosis on ultrasound) and 100% among symptomatic patients (symptoms resolution).
Aesthetical results were excellent.
Discussion and Conclusions OTAP is safe, feasible, and efficacious. Operative times are similar or even shorter
than those of other minimally invasive techniques and complication rate agrees with
the findings of literature. OTAP can be considered a reasonable alternative.
Keywords
OTAP - pyeloplasty - hydronephrosis - pyelo-ureteral junction stenosis
