Laparoscopic Dismembered Pyeloplasty in 47 Cases

Mitre, Anuar Ibrahim; Brito, Artur Henrique; Srougi, Miguel

doi:10.1590/s1807-59322008000500011

Cited by 11 publications

(7 citation statements)

References 29 publications

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“…Evaluating large series of LP ( Table 3 ), laparoscopy is usually associated with a shorter hospital stay, but has a longer operative duration and is more difficult to learn than standard open pyeloplasty [18–23] .…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic management of primary pelvi-ureteric junction obstruction: Single-centre experience

Nour

Mostafa

Gobashy

et al. 2011

Arab Journal of Urology

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ObjectiveTo evaluate the effect and safety of laparoscopic pyeloplasty in the treatment of pelvi-ureteric junction obstruction (PUJO).Patients and methodsIn 34 patients, laparoscopic dismembered pyeloplasty was used to treat primary PUJO. Information was obtained for symptoms, results of a nuclear scan before and after surgery, intraoperative blood loss, operative duration, stenting method, and hospital stay. Under general anaesthesia and in the flank position, a 10 mm trocar was first placed above the umbilicus; three 5 mm working ports were then placed. The ureter and pelvis were freed from surrounding adhesions. The obstructive pelvi-ureteric segment was then excised, and the opened point of the ureter spatulated. Ureteropyeloplasty between the lower pole, pelvis and spatulated ureter was made using a 4-0 polyglactin suture around a JJ stent.ResultsThe mean (SD) preoperative nuclear scan result was 23.6 (6.4) mL/min, with retention of tracer. The median operative duration was 200 min, and the median blood loss 120 mL. All patients were stented with a JJ stent. The mean hospital stay was 5 days. The final results were assessed at 6 months after surgery, when the mean (SD) nuclear scan result was 30 (7.4) mL/min.ConclusionLaparoscopic pyeloplasty is a safe and effective option which can produce satisfactory results both clinically and radiologically.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic management of primary pelvi-ureteric junction obstruction: Single-centre experience

Nour

Mostafa

Gobashy

et al. 2011

Arab Journal of Urology

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“…The dismembered technique should always be considered, even in the presence of anomalous vessel, because in more than half of the cases there is an associated intrinsic stenosis (9).…”

Section: Commentsmentioning

confidence: 99%

Transperitoneal laparoscopic pyeloplasty: Brazilian initial experience with 55 cases

et al. 2010

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Purpose: To evaluate prospectively the results obtained in 55 patients undergoing laparoscopic pyeloplasty through transperitoneal access. Materials and Methods: From January 2005 to July 2009, fifty-five patients between 13 and 64 years old, were treated for ureteropelvic junction (UPJ) stenosis via a transperitoneal laparoscopy. All patients had clinical symptoms of high urinary obstruction and hydronephrosis confirmed by imaging methods. Anderson-Hynes dismembered pyeloplasty was performed in 51 patients and Fenger technique in the other 4 cases. Patients were clinically and imaging evaluated in the postoperative period at 3 and 6 months and then followed-up annually. Results: The operative time ranged from 95 to 270 min. The mean hospital stay was 2 days. The average blood loss was 170 mL. The time to return to normal activities ranged from 10 to 28 days. Anomalous vessels were identified in 27 patients, intrinsic stenosis in 23 patients and 5 patients had high implantation of the ureter. Laparoscopic pyelolithotomy was successfully performed in 6 patients with associated renal stones. That series monitoring ranged from 1 to 55 months. One patient had longer urinary fistula (11 days), 3 patients had portal infection and 6 patients had prolonged ileus. There was one conversion due to technical difficulties. From the later postoperative complications, 2 patients had re-stenosis, one determined by Anderson-Hynes technique and the other by Fenger technique. The success rate was 95.65%. Conclusions: Laparoscopic pyeloplasty has functional results comparable to conventional open technique. It offers less morbidity, with aesthetic and post-operative convalescence benefits and lower complication rates.

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“…Anderson-Hynes dismembered technique is used in most series of published laparoscopic pyelo-plasties, reflecting an attempt to reproduce the well-established principles of open surgery [3,10], besides being more effective than other minimally invasive procedures [7,8,9]. The dismembered technique should always be considered, even in the presence of anomalous vessel, because in more than half of the cases there is an associated intrinsic stenosis [11].…”

Section: Resultsmentioning

confidence: 99%

Laparoscopic Dismembered Pyeloplasty for Ureteropelvic Junction Obstruction: Our Preliminary Experience

et al. 2020

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Objective: To evaluate prospectively the results obtained in 16 patients undergoing laparoscopic pyeloplasty through transperitoneal access. Materials and Methods: The study was conducted in the department of urology, BSMMU, Dhaka between the periods of March 2013 and June 2014, sixteen patients between 15 and 48 years old, were treated for ureteropelvic junction obstruction (UPJO) via a transperitoneal laparoscopy. All patients had clinical symptoms of urinary obstruction and hydronephrosis were confirmed by imaging methods. Anderson-Hynes dismembered pyeloplasty was performed in all patients. Patients were clinically and imaging evaluated in the postoperative period at 6 and 12 weeks. Results: Most of the patients were male (68.75%) and female were 31.25%. The mean operative time was 127.37 (±15.67) minutes ranged from 95 to 240 minutes. Pain score in first postoperative day and third postoperative day following pyeloplasty were 20.87 (±6.83) and 4.75 (±3.34) respectively. The mean hospital stay was 4.25 (±1.34) days. Anomalous vessels were identified in 4 patients, intrinsic stenosis in 12 patients. Postoperative urine leakage and UTI were seen 18.75%, 12.50% subject respectively. Split renal function and GFR were significantly improved (p<0.05) and improvement of renal functional outcome was 87.50%. Conclusion: Laparoscopic pyeloplasty had the advantages like less postoperative pain and shorter hospital stay. Bangladesh Journal of Urology, Vol. 19, No. 2, July 2016 p.59-63

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Laparoscopic Dismembered Pyeloplasty in 47 Cases

Cited by 11 publications

References 29 publications

Laparoscopic management of primary pelvi-ureteric junction obstruction: Single-centre experience

Laparoscopic management of primary pelvi-ureteric junction obstruction: Single-centre experience

Transperitoneal laparoscopic pyeloplasty: Brazilian initial experience with 55 cases

Laparoscopic Dismembered Pyeloplasty for Ureteropelvic Junction Obstruction: Our Preliminary Experience

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