Surgical correction of pelviureteric junction obstruction in childhood : dorsal lumbotomy approach and selective internal ureteric stenting

Ninety-four children (average age 3.6 years) underwent surgery for pelviureteric junction (PUJ) obstruction between 1994 and 1999. There were 96 operations: 94 dismemberment pyeloplasties (2 bilateral) and 2 ureterocalycostomies. The surgical approach in all cases was by a dorsal lumbotomy incision. Internal ureteric stenting was employed selectively for solitary kidneys, inflamed renal pelves, long strictures, and ureterocalycostomies. The average operative time was 57 min and the average postoperative stay in hospital was 2.5 days. Of the 94 patients, 93 had a good outcome. Of the 78 pyeloplasties that were unstented, 7 (9%) required stenting in the early postoperative period for urinary leak or obstruction. There were no wound-related complications. PUJ surgery via a dorsal lumbotomy approach with selective internal ureteric stenting is recommended as a safe and effective approach to PUJ obstruction in childhood.