{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T12:18:56Z","timestamp":1788437936170,"version":"build-2803163510"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,9]]},"abstract":"\n A\n BSTRACT<\/jats:sc>\n <\/jats:title>\n \n Background:<\/jats:title>\n Pelviureteric junction obstruction (PUJO) is a leading cause of pediatric hydronephrosis. Open pyeloplasty (OP) remains the standard treatment, but laparoscopic pyeloplasty (LP) is increasingly adopted. Comparative pediatric data on inflammatory and perioperative outcomes remain limited.<\/jats:p>\n <\/jats:sec>\n \n Objective:<\/jats:title>\n To compare perioperative outcomes, inflammatory responses, and recovery profiles between OP and LP in children with PUJO.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n \n We conducted a prospective, nonrandomized, comparative study (December 2017\u2013June 2025) including pediatric patients undergoing pyeloplasty. Patients were allocated to OP or LP based on surgical unit assignment, with family preference considered. All eligible families were counseled about both surgical options. A closed-suction drain was placed in all patients (retroperitoneal in OP and intraperitoneal in LP). Exclusion criteria included additional urinary tract anomalies, recurrent PUJO, vesicoureteral reflux, conversion to open surgery, and <1-year follow-up. Perioperative data, postoperative complications, and recovery metrics were recorded. Interleukin-6 (IL-6), IL-10, and lactate were measured at baseline, intraoperatively, immediately postoperatively, and at 48 h. Outcomes were compared using standard statistical tests, with\n P<\/jats:italic>\n \u2264 0.05 considered significant.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Of 118 patients, 106 completed analysis (OP: 56, LP: 50). Age ranged from 6 months to 14 years (OP: 6.2 \u00b1 2.8 years; LP: 6.5 \u00b1 2.7 years). No anastomotic leaks or urinary extravasation occurred in either group. Baseline demographics were comparable. LP had longer operative times (136 \u00b1 18 vs. 102 \u00b1 14 min,\n P<\/jats:italic>\n < 0.001) but reduced analgesic requirements and shorter analgesic duration (\n P<\/jats:italic>\n < 0.001). Nonsteroidal anti-inflammatory drug use was required only in OP (14%,\n P<\/jats:italic>\n = 0.005). OP showed higher incidence of flank bulges and longer IV fluid support (\n P<\/jats:italic>\n = 0.005). Cytokine analysis revealed an early IL-6 surge in LP, attributed to pneumoperitoneum, but OP demonstrated higher IL-6 and IL-10 at 48 h, indicating sustained inflammation. Lactate elevations were transient and comparable. Renal functional outcomes were equivalent at 1 year.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n LP offers comparable success with several perioperative benefits, including reduced pain, fewer wound-related complications, and attenuated late inflammatory response, particularly in experienced hands with adequate laparoscopic infrastructure, supporting its role as an effective alternative to OP in children.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jiaps.jiaps_66_26","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T12:00:13Z","timestamp":1780488013000},"page":"739-745","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Postoperative Inflammatory Response and Recovery following Pediatric Pyeloplasty: A Comparative Study of Laparoscopic and Open Approaches"],"prefix":"10.4103","volume":"31","author":[{"given":"Bhanumurthy Kaushik","family":"Marripati","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qumaruzzama","family":"Ansari","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Career Institute of Medical Sciences and Hospital, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arj Deo","family":"Upadhayay","sequence":"additional","affiliation":[{"name":"Consultant Pediatric Surgeon, Endosurgery Clinic, Varanasi, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paresh","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiv Prasad","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaibhav","family":"Pandey","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"key":"R1-20260903","first-page":"4922","article-title":"An updated meta-analysis of laparoscopic versus open pyeloplasty for ureteropelvic junction obstruction in children","volume":"8","author":"Huang","year":"2015","journal-title":"Int J Clin Exp Med"},{"key":"R2-20260903","doi-asserted-by":"crossref","first-page":"94","DOI":"10.5489\/cuaj.817","article-title":"Prospective cost analysis of laparoscopic versus open pyeloplasty in children: Single centre contemporary evaluation comparing two procedures over a 1-year period","volume":"7","author":"Moore","year":"2013","journal-title":"Can Urol Assoc J"},{"key":"R3-20260903","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/s00383-013-3433-2","article-title":"Inflammatory response after open and laparoscopic Nissen fundoplication in children: A randomized study","volume":"30","author":"Knatten","year":"2014","journal-title":"Pediatr Surg Int"},{"key":"R4-20260903","doi-asserted-by":"crossref","first-page":"268","DOI":"10.17772\/gp\/2072","article-title":"Comparison of tissue trauma after abdominal, vaginal and total laparoscopic hysterectomy","volume":"86","author":"Oksuzoglu","year":"2015","journal-title":"Ginekol Pol"},{"key":"R5-20260903","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1590\/S0100-69912012000100008","article-title":"Evaluation of serum levels of interleukin-6 and interleukin-10 in patients undergoing laparoscopic versus conventional cholecystectomy","volume":"39","author":"Silveira","year":"2012","journal-title":"Rev Col Bras Cir"},{"key":"R6-20260903","doi-asserted-by":"crossref","first-page":"255","DOI":"10.3389\/fped.2017.00255","article-title":"Influence of age and other factors on cytokine expression profiles in healthy children-a systematic review","volume":"5","author":"Decker","year":"2017","journal-title":"Front Pediatr"},{"key":"R7-20260903","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1007\/s12262-011-0237-2","article-title":"Laparoscopic versus open pyeloplasty: Comparison of two surgical approaches \u2013 A single centre experience of three years","volume":"73","author":"Bansal","year":"2011","journal-title":"Indian J Surg"},{"key":"R8-20260903","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1089\/end.2006.0411","article-title":"Laparoscopic pyeloplasty compared with open pyeloplasty in children","volume":"21","author":"Ravish","year":"2007","journal-title":"J Endourol"},{"key":"R9-20260903","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1016\/j.juro.2006.04.073","article-title":"Retrospective comparison of retroperitoneal laparoscopic versus open dismembered pyeloplasty for ureteropelvic junction obstruction","volume":"176","author":"Zhang","year":"2006","journal-title":"J Urol"},{"key":"R10-20260903","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.jpurol.2012.01.007","article-title":"Laparoscopic transperitoneal pyeloplasty in children from age of 3 years: Our clinical outcomes compared with open surgery","volume":"9","author":"van der Toorn","year":"2013","journal-title":"J Pediatr Urol"},{"key":"R11-20260903","doi-asserted-by":"crossref","first-page":"23","DOI":"10.2176\/nmccrj.cr.2016-0084","article-title":"Abdominal flank bulging after lateral retroperitoneal approach: A case report","volume":"4","author":"Choi","year":"2017","journal-title":"NMC Case Rep J"},{"key":"R12-20260903","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1001\/archsurg.1994.01420310085015","article-title":"The retroperitoneal incision. An evaluation of postoperative flank 'bulge'","volume":"129","author":"Gardner","year":"1994","journal-title":"Arch Surg"},{"key":"R13-20260903","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1159\/000517288","article-title":"Permanent flank bulge after flank incision: Patient- and physician-reported outcome","volume":"106","author":"Kranz","year":"2022","journal-title":"Urol Int"},{"key":"R14-20260903","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1007\/s00464-008-9859-2","article-title":"Cytokine responses following laparoscopic or open pyeloplasty in children","volume":"23","author":"Wang","year":"2009","journal-title":"Surg Endosc"},{"key":"R15-20260903","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/S0020-7292(03)00271-6","article-title":"A randomized study of total abdominal, vaginal and laparoscopic hysterectomy","volume":"83","author":"Ribeiro","year":"2003","journal-title":"Int J Gynaecol Obstet"},{"key":"R16-20260903","first-page":"5","article-title":"A comparative study between open and laparoscopic pyeloplasty","volume":"9","author":"Fahad","year":"2017","journal-title":"J Pharm Sci"},{"key":"R17-20260903","first-page":"324","article-title":"Is laparoscopic pyeloplasty a comparable option to treat Ureteropelvic junction obstruction (UPJO)? A comparative study","volume":"66","author":"Memon","year":"2016","journal-title":"J Pak Med Assoc"},{"key":"R18-20260903","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1007\/s00268-001-0066-8","article-title":"Lactate metabolism during laparoscopic cholecystectomy: Comparison between CO2 pneumoperitoneum and abdominal wall retraction","volume":"25","author":"Ortiz-Oshiro","year":"2001","journal-title":"World J Surg"}],"container-title":["Journal of Indian Association of Pediatric Surgeons"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jiaps.jiaps_66_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T12:03:27Z","timestamp":1788437007000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jiaps.jiaps_66_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,29]]},"references-count":18,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/jiaps.jiaps_66_26","relation":{},"ISSN":["0971-9261","1998-3891"],"issn-type":[{"value":"0971-9261","type":"print"},{"value":"1998-3891","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,29]]},"assertion":[{"value":"2026-02-07","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-10","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}