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

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

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.

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.

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.