Different Surgical Approaches for Treatment of UPJ Obstruction in Children: Prospective Randomized Clinical Trial

Study Overview
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Brief Summary
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This study aimed to evaluate the clinical efficacy of laparoscopic pyeloplasty (LP) for ureteropelvic junction obstruction (UPJO) via retroperitoneal and transperitoneal approaches.

Detailed Description
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Ureteropelvic junction obstruction (UPJO) is the most common congenital abnormality of the kidney and is responsible for flank pain, recurrent urinary infections, hydronephrosis and the loss of renal function. Until recently, open pyeloplasty (OP) was the standard surgical treatment modality for UPJO.However, with the development of laparoscopic devices and surgical technology, laparoscopic pyeloplasty (LP) has become a more beneficial choice for the patients with UPJO than open surgery because of the advantages of excellent visualization, minimal trauma, rapid postoperative recovery, good cosmetic result, and a nearly successful rate compared with open pyeloplasty. The first LP in children was performed in 1995. It has gained popularity for older children. LP can be performed though retroperitoneal and transperitoneal approaches. Which surgical method is better is still controversial.

Official Title
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Different Surgical Approaches for Treatment of UPJ Obstruction in Children: Prospective Randomized Clinical Trial

Conditions
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Urologic Diseases, Surgery

Intervention / Treatment
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* Procedure: Laparoscopic pyeloplasty


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age above two years. Unilateral UPJO. Exclusion Criteria: Age below two years. Bilateral UPJO. Recurrent UPJO. Malrotated kidneys and renal fusion anomalies.

Ages Eligible for Study
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Minimum Age: 2 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Transperitoneal approach laparoscopic pyeloplasty. (TALP)<br>Transperitoneal approach laparoscopic pyeloplasty. (TALP) | Procedure: Laparoscopic pyeloplasty<br>* Twenty patients presented with ureteropelvic junction obstruction [UPJO] will be divided into two equal groups. The first was subjected to trans-peritoneal pyeloplasty while the second was subjected to retroperitoneal pyeloplasty.<br>|
| Retroperitoneal Approach laparoscopic pyeloplasty. (RALP)<br>Retroperitoneal Approach laparoscopic pyeloplasty. (RALP) | Procedure: Laparoscopic pyeloplasty<br>* Twenty patients presented with ureteropelvic junction obstruction [UPJO] will be divided into two equal groups. The first was subjected to trans-peritoneal pyeloplasty while the second was subjected to retroperitoneal pyeloplasty.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Operative time | Operative time | From April 1, 2023 to April 1, 2024 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Convergence rate | Convergence to open pyeloplasty | From April 1, 2023 to April 1, 2024 | 
| Post operative complications | Post operative complications | From April 1, 2023 to April 1, 2024 | 
| Hospital stay | Hospital stay | From April 1, 2023 to April 1, 2024 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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UPJ obstruction, pediatric urology, pyeloplasty