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Introduction: The interest in laparoscopy in the treatment of ureteropelvic junction obstruction (UPJO) in children under 12 months of age remains controversial. The aim of this study is to evaluate feasibility and benefits of retroperitoneal laparoscopy (RL) compared to open surgery in this age group.Materials and Methods: Between January 2012 and May 2017, we performed 222 pyeloplasties: 144 by laparoscopy and 78 by open surgery. From 2012, the choice of operative technique was decided according to the laparoscopic experience of the surgeon; two surgeons operated laparoscopically on all children

Introduction: The aim is to compare the outcome of open versus laparoscopic Lich-Gregoir technique in patients with vesicoureteral reflux. We report a retrospective multicenter comparative study between open and laparoscopic extra-vesical ureteral reimplantation (EVUR) following Lich-Gregoir (LG) technique for the correction of Vesico-Ureteral Reflux (VUR).Materials and Methods: Between January 2007 and December 2015, 96 patients with VUR (69 females and 27 males) and deterioration of the renal function, underwent EVUR following LG technique. Fifty patients (16 males and 34 females) were operated by open surgery (group A). The mean age was 4.22 years-old, (14–147 months). Laparoscopic approach (group B) was performed in 46 patients (11 males and 35 females). The mean age was 4.19 years-old (15–110 months). We compared the results in relation to degree of VUR, operative time, hospital stay, post-operative pain medications, recovery time, complications, successful rate, recurrence, and follow-up. Statistical analysis was done used Chi square test for categorical variables and the Student t-test for continuous variables. P < 0.05 was considered significant.Results: In both groups no correlation was identified between age or weight and operative time, length of stay or total analgesia used. The mean operative time for group A was 63.2 and 125.4 min for unilateral and bilateral VUR, respectively, and for the group B was 127.90 and 184.5 min, respectively. There was no conversion in the laparoscopic group. Perioperative mucosal perforation of the bladder occurred in 6 patients of group A and 4 patients of group B and was immediately repaired. One patient had to be reoperated for leakage in group B. The mean duration of Morphine, IV and PO analgesia was shorter in group B. The mean hospital stay was 5.46 days for group A and 1.54 days for Group B. The success rate was 98% in group A and 97, 8% in group B. The mean follow-up was 3.67 years for the open and 1.54 years for the laparoscopic group. Transitory voiding dysfunction occurred in bilateral EVUR in one case in each group.Conclusion: Laparoscopic or Open approach for the correction of VUR following Lich-Gregoir technique is effective in unilateral and bilateral VUR with similar results. Laparoscopic approach reduces significantly (p < 0.05 in each item) post-operative pain medication, hospital stay, and allows for a faster return to normal activity.

Objectives: This study is to compare the short and long-term renal function between adult recipients of living laparoscopic and open donors (LR vs OR) to highlight the effect of the surgical technique on graft function. Moreover, we chose to compare the organic (hypertension, proteinuria, serum creatinine) and psychological (aspect of libido, need for anxiolytics) long-term effect of the surgery between laparoscopic and open donors (LD vs OD)., Methods: After census of adult recipients and living donors between 2003 and 2012, and after application of exclusion criteria and selection of homogeneous groups of donors and recipients, a retrospective cohort study was conducted between October 2008 and January 2012. In recipients, renal function in the short term was reported by the value of serum creatinine at ± D5 post-op and the long-term values of serum creatinine at 6 and 12 months after surgery. Delayed graft function was defined by a serum creatinine value ≥ 2.5 mg/dl on D5 post-op. A questionnaire for donors was established., Results: The two groups OR and LR were homogeneous concerning age, sex and body mass index (BMI). Different groups OD and LD, chosen according to the variable of interest, were made homogeneous. Despite a different warm ischemia time between the 2 groups (175.54 seconds in LR vs 44.67 seconds in OR, p < 0.001), renal function in the short- and long-term in recipients was not statistically different (At day 5, 1.54 vs 1.50 mg/dl, p = 0.781; at 6 months, 1.37 vs 1.38, p = 0.871; at 12 months, 1.34 vs 1.36, p = 0.569, in OR and LR respectively). Similarly, there was no significant statistical difference concerning organic and psychological complications between OD and LD except for a shorter period between hospital discharge and return to work in LD., Conclusion: In our center, renal function in the short- and long-term was similar in OR and LR. Apart from the advantages offered by the laparoscopic technique, organic and psychological long-term effects were similar between OD and LD. Nevertheless, laparoscopy seemed to facilitate kidney donation and is requested by almost all living donors independently of their social status.