Observation on the Effects of Different Methods of Dismembered Pyeloureteroplasty on Children with Hydronephrosis Caused by Ureteropelvic Junction Obstruction

ZHANG Chenghu; SU Chenlin; MIAO Jiayuan; XU Weixian; WU Lijun; ZHAO Xiaobo

doi:10.3969/j.issn.1002-3429.2025.14.012

Abstract：Objective To explore the effects of different methods of dismembered pyeloureteroplasty on children with hydronephrosis caused by ureteropelvic junction obstruction(UPJO).Methods A total of 96 children with hydronephrosis caused by UPJO who were admitted from May 2019 to June 2023 were selected and all underwent dismembered pyeloplasty.According to the differences in surgical methods,they were divided into the observation group(using the umbilical three-channel laparoscopic approach,n=41)and the control group(using the traditional three-port laparoscopic peritoneal approach,n=55).The duration of operation,intraoperative blood loss,removal time of abdominal drainage tube and postoperative hospital stay were compared between the two groups.The separation distances of renal calyces and renal pelvis and the anteroposterior diameters of renal pelvis before and after the operation were compared between the two groups.The levels of serum C reactive protein(CRP)and interleukin-6(IL-6)at 1 d before the operation and at 5 day after the operation were compared between the two groups.The serum creatinine(Scr),blood urea nitrogen(BUN)and glomerular filtration rate of the two groups were compared at 1 d before the operation and at 5 d after the operation.The occurrence of complications within 7 d after the operation was compared between the two groups.Results The duration of operation and drainage tube removal time in the observation group were both shorter than those in the control group(P<0.01).After the operation,the separation distances of renal calyces and renal pelvis in both groups and the anteropothior diameters of renal pelvis in each group were improved compared with those before the operation(P<0.05),but there was no significant difference between the two groups(P>0.05).The levels of CRP and IL-6 in both groups increased after the operation compared with those before the operation,and the levels in the observation group were lower than those in the control group(P<0.05,P<0.01).The levels of Scr and BUN in both groups after the operation were lower than those before the operation(P<0.05),and the glomerular filtration rate was higher than that before the operation(P<0.05),but there was no significant difference between the two groups(P>0.05).There was no significant difference in the total incidence of postoperative complications between the two groups(P>0.05).Conclusion Transumbilical three-channel laparoscopic dismembered pyeloplasty has a definite effect in the treatment of children with hydronephrosis caused by UPJO.It has shorter duration of operation,faster postoperative recovery,milder postoperative inflammatory response and higher safety.