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S28-6
(PP)
RETROPERITONEAL LAPAROSCOPIC PYELOPLASTY IN CHILDREN: OUTCOME IN
THE FIRST 4 YEARS AFTER COMPLETING A PEDIATRIC UROLOGY FELLOWSHIP
Gaston DE BERNARDIS
1
, Thomas BLANC
1
, Nathalie BOTTO
1
, Julien ROD
1
, Véronique ROUSSEAU
1
, Alaa CHEIKHELARD
1
,
Alaa EL GHONEIMI
2
, Henri LOTTMANN
1
and Yves AIGRAIN
1
1) Necker Enfants Malades University Children Hospital, Department of pediatric surgery and urology, Paris, FRANCE - 2)
Robert Debré Hospital, Department of pediatric surgery and urology, Paris, FRANCE
PURPOSE
To report the outcomes of retroperitoneal laparoscopic pyeloplasty in Children performed by two academic Pediatric
Urologists in the first 4 years of practice after completing a 2-year fellowship.
MATERIAL AND METHODS
A prospective study of all children with PUJ obstruction treated by laparoscopic pyeloplasty by two surgeons (TB and NB)
between January 2011 and January 2015 was performed (n=67). The two surgeons had completed a 2-year Pediatric
Urology fellowship. Dismembered pyeloplasty and anastomosis were performed using running monofilament 6-0
absorbable suture. All were drained by double-J stent.
RESULTS
All the children but 4 had a retroperitoneal laparoscopic pyeloplasty. Transperitoneal laparoscopic pyeloplasty was used
for horseshoe kidney (n=2), ectopic kidney (n=1) or redo procedure (n=1) Mean age was 8 yr (0.9-16.5). Three
patients had a solitary kidney. 25 patients (40%) had crossing vessels. Mean operative time was 210min (120-330).
Conversion to open surgery was needed in four patients: fibro epithelial polyp, giant hydronephrosis, anaesthetic issue
and peritoneal opening. Mean hospital stay was 1.6 days (1-5) and 60% were discharged the day after the procedure.
Transient anastomotic leakage occurred in 2 patients and was successfully treated by conservative management. Redo
pyeloplasty was needed in only one child. Mean follow-up was 1 yr (0.3-3.4).
CONCLUSIONS
Retroperitoneal laparoscopic pyeloplasty in children can now be successfully transferred to the new generation of
specialty-trained Pediatric Urologists. Modern pediatric fellowship training allows performing such a difficult procedure
with results comparable to those published by our mentor.