Approach to kidney stones associated with ureteropelvic junction obstruction during laparoscopic pyeloplasty

Rivas, Juan Gómez; Gregorio, Sergio Alonso y; Sánchez, Leslie Cuello; Guérin, C; Gómez, Andrés Montero; Togores, Luis Hidalgo; Barthel, Jesús Javier de la Peña

doi:10.5173/ceju.2013.04.art13

Cited by 11 publications

(8 citation statements)

References 14 publications

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“…There are no statistically significant differences in the literature between these two approaches therefore, surgeon preferences and experience remains the main determinant of choice for the procedure [ 17 ]. From our point of view, the transperitoneal approach offers the technical advantages of a wider operative field, with better view of anatomical references, allowing easier ureteral transposition for selected cases and also making possible the treatment of associated kidney stones [ 4 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

Evolution in the treatment of the ureteropelvic junction obstruction syndrome. Laparoscopic versus open pyeloplasty

Rivas

Gregorio

Sánchez

et al. 2015

CEJU

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IntroductionThe treatment of ureteropelvic junction has evolved considerably over the past 20 years, resulting in new surgical techniques, but traditional open surgery remains the gold standard treatment. Currently, less invasive techniques are used for the treatment of ureteropelvic junction obstruction. The purpose of our study is to compare the surgical and functional results between laparoscopic and open pyeloplasty performed at our department during the last 12 years.Material and methodsThis is a retrospective review of 92 cases performed in a period of 12 years. Two groups were compared: 30 patients were treated with open surgery (OP) and 62 with a laparoscopic approach (LP). Demographics, clinical presentation, functionality of the affected kidney, presence of polar vessels, kidney stones, hospital stay, complications and functional results were statistically analyzed.ResultsThe mean age was 42 years. The most common clinical presentation was kidney or ureteral pain: 60% (OP) vs. 52% (LP). The right side was affected in 59%; presence of crossing vessels was 47% (OP) vs. 58% (LP); presence of kidney stones was 20% (OP) vs. 19% (LP), with an average hospital stay of 5.86 days (OP) vs. 3.36 days (LP) p <0.05. Post-operative complications were observed in 3 (OP) vs. 5 (LP) patients, with a success rate comparable between groups.ConclusionsIn our department, we recommend LP as the standard treatment for ureteropelvic junction obstruction because of the equal success rate compared to OP and the benefits of a minimally invasive surgery.

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Section: Discussionmentioning

confidence: 99%

Evolution in the treatment of the ureteropelvic junction obstruction syndrome. Laparoscopic versus open pyeloplasty

Rivas

Gregorio

Sánchez

et al. 2015

CEJU

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“…The transperitoneal approach is more familiar to most surgeons and offers the following advantages: much wider workspace that would allow easier addition of techniques, such as transposition of polar vessels or remodeling of the pelvis and resolution of secondary lithiasis, and the anatomical landmarks allow better guidance and more easily reproduce the steps of open surgery [12].…”

Section: Discussionmentioning

confidence: 99%

“…Inagaki et al [14] reported the presence of kidney stones in 16% of patients. Rivas et al [12] reported on concomitant kidney stones in 12 of 62 patients (19%) who had undergone transperitoneal TLP. They removed stones in eight cases using a flexible cystoscope and a nitinol N-circle basket, whereas in the remaining four cases the stones were extracted using laparoscopic grasping instruments.…”

Section: Discussionmentioning

confidence: 99%

Transperitoneal laparoscopic pyeloplasty in children and adolescents

Elemam¹,

Shalaby²,

Ismail³

et al. 2015

Annals of Pediatric Surgery

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Background Open pyeloplasty has been the gold standard for the treatment of ureteropelvic junction obstruction (UPJO) in children and young adolescents. However, the use of laparoscopy for the treatment of pyeloplasty is increasing as it has the potential to provide a better and more desirable cosmetic outcome in addition to less postoperative pain and decreased recovery time. The aim of this study was to evaluate the long-term outcome of transperitoneal laparoscopic pyeloplasty (TLP) for the treatment of UPJO in children and young adolescents.Patients and methods Twenty-nine patients with UPJO with 32 renal units were subjected to TLP at Al-Azhar University Hospitals, Egypt, during the period from May 2008 to December 2012. The outcome measurements of this study included operative time, internal stent placement, hospital stay, intraoperative complications, and success rates. Success is defined as both symptomatic relief and radiographic resolution of hydronephrosis at the last follow-up. Patients were followed up with intravenous urography and diethylene triamine penta-acetic acid scan at 3, 6, and 12 months regularly for both functional and morphological outcomes. ResultsThe study included 29 patients (12 male and 17 female) with 32 obstructed renal units. The mean age was 4.23 ± 2.1 years (range 3-16 years). All procedures were completed laparoscopically without conversion. The mean operative time was 143.41 ± 23 min (range 110-220 min). The mean postoperative hospital stay was 4.1 days (range 3-8 days). All patients achieved full recovery without any complications. The mean follow-up period of the patients was 36.34 ± 5.18 months (range 22-60 months). Success rate was 96.9%. Only one case developed recurrent UPJO and was treated with retrograde endopyelotomy and stenting.Conclusion TLP has the advantages of less postoperative pain, short hospital stay, and rapid recovery, with excellent functional and cosmetic outcomes. However, it requires advanced skill level for intracorporeal suturing and knot tying.

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“…4 With advances in surgical techniques, minimally invasive surgeries, such as percutaneous nephrolithotomy (PCNL) with endopyelotomy (EP), laparoscopic pyeloplasty (LP), and robotic-assisted laparoscopic pyeloplasty (RALP) with concomitant pyelolithotomy, have been more widely adopted in managing these cases. 5–7 However, each of these procedures has its own limitations, and there is controversy regarding whether one of these procedures is superior to the others regarding management of individual patients.…”

Section: Introductionmentioning

confidence: 99%

Concomitant management of renal calculi and recurrent ureteropelvic junction obstruction with percutaneous nephrolithotomy and antegrade balloon dilation

et al. 2020

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Objective This study aimed to present our experience of concomitant management of renal calculi and recurrent ureteropelvic junction obstruction (UPJO) with percutaneous nephrolithotomy (PCNL) and antegrade balloon dilation. Methods We retrospectively reviewed 31 patients who underwent PCNL and antegrade balloon dilation for treatment of renal calculi and recurrent UPJO. The inclusion criterion was the presence of UPJO after failed pyeloplasty with ipsilateral renal calculi. Success was defined as achievement of both symptomatic and radiographic resolution of any stones and obstruction. Results All operations were successful without grade III or higher postoperative complications. A stone-free status was observed in all patients and the overall success rate of the procedure was 87.1% (27/31). The success rate of the procedure was significantly higher in patients with mild or moderate preoperative hydronephrosis (96%) than in those with high-grade preoperative hydronephrosis (50%). Moreover, the success rate of the procedure was lower in patients with poor preoperative renal function (0%) than in those with good or moderate renal function (93.1%). Conclusion Combined PCNL and antegrade balloon dilation management represents a safe and effective approach for patients with renal calculi and recurrent UPJO after failed pyeloplasty.

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Approach to kidney stones associated with ureteropelvic junction obstruction during laparoscopic pyeloplasty

Cited by 11 publications

References 14 publications

Evolution in the treatment of the ureteropelvic junction obstruction syndrome. Laparoscopic versus open pyeloplasty

Evolution in the treatment of the ureteropelvic junction obstruction syndrome. Laparoscopic versus open pyeloplasty

Transperitoneal laparoscopic pyeloplasty in children and adolescents

Concomitant management of renal calculi and recurrent ureteropelvic junction obstruction with percutaneous nephrolithotomy and antegrade balloon dilation

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