Dorsal lumbotomy approach for paediatric pyeloplasty.

Abstract

Objective: To assess the outcomes of dorsal lumbotomy approach for paediatric pyeloplasty in terms of duration of surgery, blood loss, hospital stay and postoperative complications. Study Design: Retrospective Review. Setting: Children Hospital, Faisalabad. Period: Aug 2021 to July 2024. Methods: The patients presented with hydronephrosis and followed by confirmed case of pelviureteric junction obstruction with DTPA renal scan, were operated in last five years with this surgical approach were reviewed retrospectively, n=126 cases. Pelviureteric junction was corrected with dismembered pyeloplasty using dorsal incision vertically named dorsal lumbotomy incision. DJ stent was placed in every case of pyeloplasty which was removed cystoscopically after 6 weeks of procedure. Results: There was total 126 patients, 82 patients were males and 44 patients were females. The mean age of patients at the time of surgery was 4.56±2.16 years. Mean duration of surgery was 52.60±8.27 minutes. Mean blood loss was 42.7 milliliters. Mean hospital stay was 3.46±1.38 days. Superficial wound infection was documented in 13 (10.3%) patients, spontaneous expulsion of DJ stent through urethra in 3 (2.4%) patients, ureterovasical junction obstruction (UVJO) was found in 6 (4.8%), incisional hernias were documented only in only 3(2.4%) patients. Cosmetic acceptance by the patients/parents of this incision was documented in 119 (94.4%) cases. After 24-month follow-up there was observed evidence of clinical and radiological improvement in 120(95.2%) patients. Conclusion: Dorsal lumbotomy approach for pediatric pyeloplasty is a safe technique for boys and girls. Post-operative morbidity, wound infection and seroma formation all are low in dorsal lumbotomy approach.