ArticleJournal of Indian Association of Pediatric Surgeons
Postoperative Inflammatory Response and Recovery following Pediatric Pyeloplasty: A Comparative Study of Laparoscopic and Open Approaches.
Article in Journal of Indian Association of Pediatric Surgeons. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Pelviureteric junction obstruction (PUJO) is a leading cause of pediatric hydronephrosis. Open pyeloplasty (OP) remains the standard treatment, but laparoscopic pyeloplasty (LP) is increasingly adopted. Comparative pediatric data on inflammatory and perioperative outcomes remain limited. Objective: To compare perioperative outcomes, inflammatory responses, and recovery profiles between OP and LP in children with PUJO. Materials and Methods: We conducted a prospective, nonrandomized, comparative study (December 2017-June 2025) including pediatric patients undergoing pyeloplasty. Patients were allocated to OP or LP based on surgical unit assignment, with family preference considered. All eligible families were counseled about both surgical options. A closed-suction drain was placed in all patients (retroperitoneal in OP and intraperitoneal in LP). Exclusion criteria included additional urinary tract anomalies, recurrent PUJO, vesicoureteral reflux, conversion to open surgery, and <1-year follow-up. Perioperative data, postoperative complications, and recovery metrics were recorded. Interleukin-6 (IL-6), IL-10, and lactate were measured at baseline, intraoperatively, immediately postoperatively, and at 48 h. Outcomes were compared using standard statistical tests, with Results: Of 118 patients, 106 completed analysis (OP: 56, LP: 50). Age ranged from 6 months to 14 years (OP: 6.2 ± 2.8 years; LP: 6.5 ± 2.7 years). No anastomotic leaks or urinary extravasation occurred in either group. Baseline demographics were comparable. LP had longer operative times (136 ± 18 vs. 102 ± 14 min, Conclusions: LP offers comparable success with several perioperative benefits, including reduced pain, fewer wound-related complications, and attenuated late inflammatory response, particularly in experienced hands with adequate laparoscopic infrastructure, supporting its role as an effective alternative to OP in children.
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