Comparison of the clinical results of pediatric patients who were opened and laparoscopic pieloplasty due to ureteropelvic conjunction stricture

Minimally invasive applications in the treatment of ureteropelvic junction stenosis (UPD) have developed significantly in the last 10 years. However, traditional open surgery remains the gold standard treatment in the surgical treatment of UPD. The aim of our study is to compare the surgical and functional results of laparoscopic and open pyeloplasty performed in children in the last 8 years in our clinic. In this study, it was planned to evaluate the results of patients who were diagnosed with ureteropelvic junction stenosis and underwent surgical treatment in the urology clinic of Çukurova University between 2012 and 2020. Patients treated with laparoscopic and traditional open surgery methods were evaluated as the study group. 194 cases aged 0-18 years, performed over an 8-year period, were retrospectively analyzed. The patients were compared as laparoscopic group and open surgery group. 164 patients were treated with open surgery (AP) and 30 patients with laparoscopic approach (LP). Demographic characteristics, clinical appearance, functionality of the affected kidney, and length of hospital stay of the cases in both groups were compared. The results were statistically analyzed. Of the patients included in the study, 94 (57.3%) were boys and 73 (44.5%) were girls. There was no difference between the two groups in terms of gender distribution (p=0.564). The mean age of the patients included in the study was 2.7 ± 1.4 years in the AP group. In the LP group, it was 8.5±5.4 years. Patients were grouped according to their symptoms at admission to the clinic. The most common complaints were 103 (53%) flank pain, 37 (19.07%) abdominal pain, 41 (21.13%) febrile UTI, 14 (7.2%) antenatal hydronephrosis. When both groups were compared in terms of operation time, the mean operation time was 122 ±35.2/min in the AP group and 200 ±66.7/min in the LP group. When the length of hospital stay was compared, the median was 3.5 days in the AP group and 3.2 days in the LP group. As a result of the study performed in our clinic, it has been shown that the results of the laparoscopic and open surgery groups in the surgical treatment of UPD in the pediatric age group are similar.