Feasibility and effectiveness of transumbilical single-site laparoscopic pyeloplasty for unilateral UPJO in infants.

Objective: We aimed to investigate the efficacy and safety of transumbilical single -site laparoscopic pyeloplasty for treating infants aged less than 12 months with Society for Fetal Urology (SFU) Grade IV hydronephrosis due to ureteropelvic junction obstruction (UPJO).

Materials And Methods: Data from 67 infants aged less than 12 months with UPJO, who underwent traditional laparoscopic pyeloplasty (TLP) or transumbilical single-site laparoscopic pyeloplasty (TSSLP) between December 2021 and March 2024, were retrospectively reviewed. The surgical technique utilized for each patient was based on the surgeon's preference. Demographics, clinical manifestations, surgical duration, hospitalization duration, complication rates, and treatment success were examined within the respective groups. Additionally, preoperative and postoperative measurements of the anterior-posterior diameter (APD) of the renal pelvis, and preoperative assessment of differential renal function (DRF) were analyzed.

Results: In this study, 21 patients who underwent TSSLP and 46 patients who underwent TLP were included. In all cases, the Anderson-Hynes technique was employed. There was no significant difference between the two groups in terms of age, body mass index, gender distribution, affected side, preoperative APD, postoperative APD, or preoperative DRF. The median operative time was 165 min (IQR: 144-206) in the TLP group, and 170 min (IQR: 150-182) in the TSSLP group (p = 0.832). Notably, the occurrence of postoperative complications was similar between the two groups (14.3 % in the TSSLP group and 17.4 % in the TLP group, p = 1.000).

Conclusion: TSSLP is a safe, effective and feasible treatment for unilateral hydronephrosis due to UPJO in infants.