• Logo
  • SBMUJournals

Open Surgery in the Era of Minimally Invasive Surgery: Pyeloplasty via A Mini Flank Incision in the Treatment of Infants with Ureteropelvic Junction Obstruction

Xiaodong Liu, Xinghuan Wang



Purpose: To evaluate the clinical effects of open pyeloplasty via a mini flank incision in the treatment of infants with ureteropelvic junction obstruction (UPJO).

Materials and Methods: We retrospectively analyzed 85 cases of infants with UPJO in our hospital from Jan. 2015 to Jan. 2018. The cases were divided into two groups according to the procedure: open pyeloplasty (n=45) and laparoscopic pyeloplasty (n=40). After 12~24 months of follow-up, the clinical effects of the two groups were compared.

Results: There was no significant difference in age between the two groups (P = .1). The operation time, postoperative fasting time and the indwelling time of the perirenal drainage tube in the open group were shorter than those in the laparoscopic group (68.0 ± 15.3 minutes versus 79.6 ± 18.8, P = .002; 5 ± 1 hours versus 14 ± 8.2 hours, P =.001; 2.8 ± 0.8 days versus 3.7 ± 1.3 days, P = .001, respectively), and there was no significant difference in the volume of intraoperative bleeding (2.1±0.9 versus 2.2±0.6, P=.55). The number of recurrences and complications in both groups were 0 versus 2 (P = .22) and 5 versus 7 (P = .40), respectively.

Conclusion: Open pyeloplasty via a mini flank incision has the advantages of being minimally invasive, safe, effective, and easy to master, and it requires a short operation time. It is a reasonable option for the treatment of infants with UPJO despite this era of minimally invasive surgery.


Ureteropelvic junction obstruction; Pyeloplasty; Minimally invasive; Infant


EAU Guidelines.Copenhagen,C. Radmayr.2018;p.60.

Cundy Thomas P, Harling Leanne, Hughes-Hallett Archie, et al. Meta-analysis of robot-assisted vs conventional laparoscopic and open pyeloplasty in children.BJU Int.2014;114:582-594.

Fernbach SK, Maizels M, Conway J J. Ultrasound grading of hydronephrosis: introduction to the system used by the Society for Fetal Urology. Pediatr Radiol, 1993;23(6): 478-480.

Peters CA, Schlussel RN, Retik AB. Pediatric laparoscopic dismembered pyeloplasty. J Urol.1995;153:1962-1965.

Reddy Mallikarjun N, Nerli Rajendra B. The laparoscopic pyeloplasty: is there a role in the age of robotics? Urol Clin North Am, 2015. 42: 43

Tasian Gregory E, Casale Pasquale. The robotic-assisted laparoscopic pyeloplasty: gateway to advanced reconstruction. Urol Clin North Am, 2015. 42: 89.

Huang Yidong, Wu Yang, Shan Wei, Zeng Li, Huang Lugang. An updated meta-analysis of laparoscopic versus open pyeloplasty for ureteropelvic junction obstruction in children. Int J Clin Exp Med.2015,8(4) :4922-4931.

Kutikov Alexander, Resnick Matthew, Casale Pasquale. Laparoscopic pyeloplasty in the infant younger than 6 months-is it technically possible? J Urol 2006;175:1477-1479.

Kafka Ilan Z, Kocherov Stanislav, Jaber Jawdat, Chertin Boris. Pediatric robotic-assisted laparoscopic pyeloplasty (RALP): does weight matter? Pediatr Surg Int.2019 ;35:391-396.

Singh O, Gupta SS, Arvind NK. Laparoscopic pyeloplasty: an analysis of first 100 cases and important lessons learned.Int Urol Nephrol.2011;43:85-90.

Cundy Thomas P, Harling Leanne, Hughes-Hallett Archie, Mayer Erik K, Najmaldin Azad S, Athanasiou Thanos, et al. Meta-analysis of robot-assisted vs conventional laparoscopic and open pyeloplasty in children. BJU Int, 2014;114: 582.

Trevisani Lorenzo F M, Nguyen Hiep T. Current controversies in pediatric urologic robotic surgery. Curr Opin Urol, 2013;23: 72.

Colaco Marc, Hester Austin, Visser William, Rasper Alison, Terlecki Ryan. Relative to open surgery, minimally-invasive renal and ureteral pediatric surgery offers no improvement in 30-day complications, yet requires longer operative time: Data from the National Surgical Quality Improvement Program Pediatrics.Investig Clin Urol.2018 05 ;59(3) :200-205.

DOI: http://dx.doi.org/10.22037/uj.v0i0.5405


  • There are currently no refbacks.