Evidence map›Paper›PMID 40652413›Full record

ArticlePediatric surgery international2025

Laparoscopic management of ureteropelvic junction obstruction in duplex kidneys: comparison of laparoscopic pyeloplasty and laparoscopic pyeloureterostomy.

Varunkumar Maddileti, Heera Tharanendran, Ramesh Babu, V V S Chandrasekharam

Abstract readComparative StudyMulticenter Study
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In one paragraph

Article in Pediatric surgery international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

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4citing papers in PubMed
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4 citing papers in PubMed.

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5 · Who and what money

Authors and funding

4 authors.

Varunkumar MaddiletiDepartment of Pediatric Surgery, Pediatric Urology and MAS, Ankura Hospitals for Women and Children, Vijayawada, Andhra Pradesh, India. drvarunkumar999@gmail.com.
Heera TharanendranDepartment of Pediatric Urology, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, Tamil Nadu, India.
Ramesh BabuDepartment of Pediatric Urology, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, Tamil Nadu, India.
V V S ChandrasekharamDepartment of Pediatric Surgery, Pediatric Urology and MAS, Ankura Hospitals for Women and Children, Hyderabad, Telangana, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeUreteropelvic junction obstruction (UPJO) in duplex systems is rare, with laparoscopic pyeloplasty (LP) and laparoscopic pyelo-ureterostomy (LPU) being the main surgical options. However, guidelines for selecting the appropriate procedure based on anatomical variations are lacking. This study evaluates the outcomes of laparoscopic management of duplex UPJO in children, comparing LP and LPU.

methodsA retrospective review was conducted on children who underwent surgery for UPJO in duplex systems at two pediatric urology centers over 10 years. Preoperative imaging included ultrasound, diuretic renogram, voiding cystourethrography, and magnetic resonance urography when needed. Retrograde pyelography confirmed anatomy. LP was preferred for lower moiety (LM) UPJO, while LPU was performed for short-segment or hypoplastic incomplete duplex. All children had double J stents for 4-6 weeks. Statistical analysis used t tests and Chi-square tests.

resultsAmong 25 children (complete: 11, incomplete: 14), LP was performed in 9/11 complete and 3/14 incomplete cases (p = 0.01). LPU was performed in 11 incomplete cases. The mean operative time was 113 min for LP and 137 min for LPU (p = 0.01). The median hospital stay was 2 days. Two children had postoperative UTIs, and one had early stent expulsion. Outcomes were favorable in all cases.

conclusionDuplex UPJO consisted of only 3.2% of a large cohort of UPJO from two busy pediatric urology centers. LP was possible in most UPJO in complete duplex, while most UPJO in incomplete duplex had to be managed with LPU. Although LPU was more challenging with longer operative time than LP, both LP and LPU had comparably good results. We strongly recommend intraoperative RGP in all cases of suspected duplex to decide the best surgical option in each case.

Indexed as

KidneyKidney PelvisLaparoscopyUreterUreteral ObstructionUreterostomyUrologic Surgical ProceduresChildChild, PreschoolFemaleHumansInfantMaleRetrospective StudiesTreatment OutcomeDuplex collecting systemLaparoscopic pyeloplastyLaparoscopic pyelo-ureterostomyUreteropelvic junction obstruction

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.