Laparoscopic Pyeloplasty with Transperitoneal Approach for Ureteropelvic Obstruction.
- Author:
Ill Young SEO
1
;
Seung Chol PARK
;
Sang Jin OH
Author Information
1. Department of Urology, Wonkwang University School of Medicine, Iksan, Korea. seraph@ wonkwang.ac.kr
- Publication Type:Original Article
- Keywords:
Ureteral obstruction;
Kidney disease;
Laparoscopy
- MeSH:
Colon, Ascending;
Constriction, Pathologic;
Female;
Flank Pain;
Follow-Up Studies;
Humans;
Hydronephrosis;
Kidney Diseases;
Laparoscopy;
Length of Stay;
Male;
Polyps;
Technetium Tc 99m Mertiatide;
Ureter;
Ureteral Obstruction;
Urography
- From:Korean Journal of Urology
2005;46(4):370-374
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Laparoscopic pyeloplasty is an alternative, minimally invasive approach for the repair of an ureteropelvic junction obstruction (UPJO). However, it has a technical difficulty, and various laparoscopic approaches are available. We present our initial experience of laparoscopic pyeloplasty using a transperitoneal approach in patients with an UPJO. MATERIALS AND METHODS: Between January 2002 and January 2004, 11 patients underwent laparoscopic pyeloplasty using a transperitoneal approach. Of these 11, 10 patients were followed up and enrolled in this study. They were comprised of 6 males and 4 females, with a mean age of 44 years (19-62). The chief complaints were flank pain in 8 patients, with a further 2 incidental detected. Three patients had had previous abdominal surgeries. The mean length of stricture was 1.1cm in the radiologic studies, and the degree of hydronephrosis was grade 3/4 in 6 patients and grade 4/4 in 4. An obstructive pattern in the 99mTc-MAG3 renal scan was present in 9 patients. RESULTS: Eight patients were treated with dismembered Anderson-Hynes pyeloplasty and 2 patients with Fenger pyeloplasty. The mean operating time and hospital stay were 225 minutes (120-450) and 7.4 days (5-10), respectively. During the operation, crossing vessels were found in 4 patients and an ureteral polyp in 1. One patient had an ascending colon injury, which was postoperatively detected and repaired. The mean follow- up period was 42.5 weeks (26-135). Follow-up excretory urography and a 99mTc-MAG3 renal scan showed improvements in 8 of the 10 patients (80%) at the 3 month follow-up. The flank pain disappeared in all the patients (100%) who had previously complained of this symptom. CONCLUSIONS: Laparoscopic pyeloplasty could be an alternative treatment for an ureteropelvic junction obstruction, especially using a transperitoneal approach, which seems to have a technical convenience over that of the retroperitoneal approach.
