Laparoscopic Versus Open Pyeloplasty: Assessment of Objective and Subjective Outcome

Bauer, John J.; Bishoff, Jay T.; Moore, Robert G.; Chen, Roland N.; Iverson, Alan J.; Kavoussi, Louis R.

doi:10.1097/00005392-199909010-00016

Cited by 240 publications

(113 citation statements)

References 22 publications

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“…However, its morbidity is high especially related to chronic pain, risk of incisional hernia and later return to 'daily activities' (6). The success rates of laparoscopic pyeloplasty were comparable to those of open surgery with long-term rates as high as 98% (12)(13)(14)(15)(16)(17)(18).…”

Section: Commentsmentioning

confidence: 99%

“…The lumbar incision adopted most of the time (lumbotomy), among other factors, leads to higher morbidity in the procedure, mainly related to the use of analgesics postoperatively and worse cosmetic effect besides a longer period of convalescence (6). (3,4).…”

Section: Commentsmentioning

confidence: 99%

“…Anderson-Hynes dismembered technique is used in most series of published laparoscopic pyeloplasties, reflecting an attempt to reproduce the wellestablished principles of open surgery (6,8), besides being more effective than other minimally invasive procedures (3,4,7). 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%

“…Laparoscopic pyeloplasty, first performed by Schuessler et al (5), in 1993, maintains the principles of open dismembered pyeloplasty, with excellent functional results and significant reductions in morbidity (6).…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Commentsmentioning

confidence: 99%

Section: Commentsmentioning

confidence: 99%

Section: Commentsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Transperitoneal laparoscopic pyeloplasty: Brazilian initial experience with 55 cases

et al. 2010

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“…For example, the success rate of laparo-scopic pyeloplasty may be higher than that of open pyeloplasty [5,6]. Laparoscopy has additional appeal for urologists, as all potential target organs (except for the mid-ureter) are relatively difficult to expose by open surgery because of the bony confines of the costal margin or pelvis.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic radical prostatectomy: the initial UK series

et al. 2002

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Bilateral neurovascular bundle preservation was attempted in 58% of patients. The transfusion rate was 3%. The conversion and re-intervention rates were 1% and 2%, respectively. There were eight complications, six of which were in the initial 26 cases, i.e. bladder neck stenosis (two), and rectal injury, laparotomy for bleeding, premature drain removal leading to urinary peritonitis, ulnar nerve neuropraxia, port-site hernia and paralytic ileus in one each. The positive surgical margin rate was 16%. All patients had a PSA level of £ 0.1 ng/mL at 3 months. By 1 year 90% of patients were pad-free and 62% operated on using a bilateral nerve-sparing technique had erections. There were no biochemical failures. The mean (range) follow-up was 9.8 (1-24) months. Conclusion The present results are similar to those reported by other centres with greater experience and confirm that LRP is an effective, safe and precise technique. Once intial experience has been gained it offers advantages over open surgery in the form of a dry and magnified operative site, and a lower likelihood of blood transfusion, in addition to the generic advantages of laparoscopy.

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Laparoendoscopic Single‐site Upper Tract Surgery

Tabib

Gaunay

Richstone

2018

Smith's Textbook of Endourology

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Laparoscopic Versus Open Pyeloplasty: Assessment of Objective and Subjective Outcome

Abstract: Pain relief, improved activity level and relief of obstruction outcomes are equivalent for laparoscopic and open pyeloplasty.

Cited by 240 publications

References 22 publications

Transperitoneal laparoscopic pyeloplasty: Brazilian initial experience with 55 cases

Transperitoneal laparoscopic pyeloplasty: Brazilian initial experience with 55 cases

Laparoscopic radical prostatectomy: the initial UK series

Laparoendoscopic Single‐site Upper Tract Surgery

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