Primary laparoscopic ureterocalicostomy as an option in selected cases of ureteropelvic junction obstruction

摘要

Abstract Purpose To evaluate the outcome of primary laparoscopic ureterocalicostomy in nine children.Methods All children who underwent laparoscopic ureterocalicostomy (LUC) as the primary procedure were included in the study. The surgery was performed by two pediatric urologists from two different institutions during the study period (2016–2022). The technique of ureterocalicostomy employed was similar in all children and consisted of identification of the most dependent portion of the lower pole calyx and anastomosis with the ureter with or without dismembering the ureteropelvic junction (UPJ). Double J stent was placed in all children for a period of 6–8 weeks; three children had an additional nephrostomy which was removed after 1 week.Results We had a total of nine children (five boys, four girls). The median age at operation was 5 years (2 months–14 years), and the mean duration of follow-up was 3 years. The indications for LUC included horseshoe kidney (4), giant hydronephrosis (1), and malrotated kidney (4). All children experienced a good outcome, as defined by reduced dilatation on post-operative ultrasonography. No children developed any complications. The mean operating time was 120 min.Conclusion Our study shows that primary laparoscopic ureterocalicostomy is a feasible and safe option for UPJ obstruction in children with a high insertion ureter and a posteriorly malrotated kidney where the lower calyx is most dependent and accessible.