WOFAPS 2025 8th World Congress of Pediatric Surgery

Beytullah Yağız, Merve Çelenk, Berat Dilek Demirel

Ondokuz Mayis University Faculty of Medicine Department of Pediatric Surgery

Introduction:

To present our experience on pyeloplasty in newborns.

Materials And Methods:

The newborns (<31 days) who underwent pyeloplasty for ureteropelvic junction obstruction between 2007 and 2025 are enrolled in the study. The demographics and clinical data are retrospectively evaluated.

Results:

A total of 17 patients with 20 renal moiety are enrolled but 2 were excluded due to nonfunctioning kidneys and only 15 moieties are enrolled as 3 moieties of 3 bilateral patients were operated after the newborn period. Eight patient underwent open, 7 underwent laparoscopic pyleoplasty. Male/female rate was 12/3. Median age at operation was 27 days (5-30). Six patients underwent preoperative nephrostomy and creatinine clearance evaluation to confirm a functional kidney. Mean postoperative DFR of these patients was 35.33 (±17.02). Mean preoperative and postoperative pelvic diameters were 37.8 (±31.72) mm and 11,4 (±10.83) mm, respectively. Nine patients underwent preoperative MAG3 scan with a median DFR of 44.77% (11-69%) which increased to 50% (1-56%). The DFR of involved renal moiety reduced in 3 patients but none are regarded failed as USG parameters improved. In median follow up of 28 months (3-171 months), none was regarded as surgical failure.

Conclusion:

Severe hydronephrosis with suspected UPJO is hard to handle in newborns. Achieving a correct diagnosis is hard as the kidney function can not be reliably evaluated in this age group. Furthermore, technique of choice is also controversial. Depending on the patient, combinations of USG, nephrostomy and scintigraphy may help the diagnosis and, both open and laparoscopic technique can be performed with outstanding success in experienced hands.