Objective The aim of our study was to explore the efficacy and safety of adjustable suspension in laparoscopic pyeloplasty (ASLP) and single-line pelvis suspension in laparoscopic pyeloplasty (SLPSLP) for isolated ureteropelvic junction obstruction (UPJO) in children. Methods We retrospectively reviewed the clinical data of all the children with isolated UPJO who underwent laparoscopic pyeloplasty (LP) at Fujian Children's Hospital between July 2019 and July 2023. We collected data from the medical records of all the children and analysed their clinical characteristics as well as their operative and follow-up data. Results One hundred thirteen children with isolated UPJO who had complete clinical data and underwent LP at our centre were included in this study. Fifty-two children underwent ASLP and 61 children underwent SLPSLP successfully at our centre. There was no statistically significant difference in patient age, sex, body weight, proportion of patients with a history of UTI or pain, follow-up time or side of the UPJO between the ASLP group and the SLPSLP group ( P 0.05). However, there were significant differences in the operation duration, blood loss volume, time to DJ stent extraction, time to abdominal drainage tube extraction and length of hospitalisation between the ASLP group and the SLPSLP group ( P 0.05). The APD and PT before surgery were significantly different from those 6 and 12 months after surgery in both the ASLP and SLPSLP groups ( p 0.05). The anastomotic leakage rate was significantly different between the two groups, as no patients in the ASLP group and 6 patients in the SLPSLP group experienced anastomotic leakage ( P = 0.030). Anastomotic stenosis occurred in 1 patient in the ASLP group and 4 patients in the SLPSLP group, with no significant difference between the two groups ( P = 0.372). Conclusion Compared with SLPSLP, ASLP is advantageous in that it is minimally invasive, has a shorter operation time, and causes less bleeding. Thus, compared with conventional LP, adjustable suspension in laparoscopic pyeloplasty involving a minimally invasive fascia closure device for paediatric isolated UPJO is safe and effective.
Xu et al. (Mon,) studied this question.