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

Abstract

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.

Management of pelviureteric junction obstruction at a tertiary teaching hospital in southwestern Nigeria: A retrospective analysis of case records

“…2,3 The overall success rate is said to be between 90% and 100%. 25,26 In our study, Anderson-Hynes dismembered pyeloplasty was performed in two-thirds of patients, with an overall success rate that is similar to that reported by other studies. 1,3,15 Foley Y-V plasty was performed in a few patients because they had grossly distended and redundant renal pelves.…”

“…The outcomes of these minimally invasive procedures have been shown to compare favourably to open pyeloplasty. [11][12][13]26 Four postoperative complications of pyeloplasty were encountered in our study. These were wound infection, py-elonephritis, shunt malfunction, and incisional hernia.…”