Comparative Study of a Modified Suture Technique with a Minimal Renal Pelvis Incision in Paediatric Hydronephrosis Treatment

Background Laparoscopic pyeloplasty (LP) is an effective treatment for ureteropelvic junction obstruction (UPJO), but research on reducing renal pelvis incision size and improving suture techniques is limited. Purpose To compare LP with a modified suture and minimal renal pelvis incision versus standard LP for treating paediatric UPJO. Methods A retrospective analysis of 120 paediatric UPJO patients who underwent surgery at the Children's Hospital of Nanjing Hospital from January 2022 to June 2024 was conducted. Among the 120 patients, 103 were male, 17 were female, and the median age was 68.0 months. One hundred cases were left-sided, and 20 were right-sided. The modified group (MG) received LP with a minimal renal pelvis incision and modified suture technique, whereas the control group (CG) underwent standard LP. There were no significant differences between the groups in terms of sex, age, side, or preoperative hydronephrosis (P > 0.05). Surgical and follow-up outcomes were compared. Results All surgeries were successful without conversion to open surgery. Compared with the CG, the MG had shorter surgery times, less blood loss, shorter hospital stays, and less postoperative haematuria (P < 0.05). One case (1.59%) of D‒J tube blockage occurred in the MG, whereas seven cases (12.28%) occurred in the CG, with significant difference (P < 0.05). After a mean follow-up of 7.0 ± 5.5 months, there were no significant differences in the anterior‒posterior diameter (APD) of the renal pelvis between the groups (P > 0.05). The reoperation rate was 1.59% for the MG and 1.75% for the CG (P > 0.05). Conclusion Compared with standard LP, LP with a modified suture and minimal renal pelvis incision offers advantages in terms of surgery time, blood loss, hospital stay, and incidence of postoperative haematuria. The reoperation rate and APD recovery were similar between the groups, and the MG had a lower incidence of D‒J tube blockage, making this technique a viable option for treating paediatric UPJO.