251. Extraperitoneal laparoscopic pyeloplasty: a multicenter study of 55 procedures.
- Author
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Soulié M, Salomon L, Patard JJ, Mouly P, Manunta A, Antiphon P, Lobel B, Abbou CC, and Plante P
- Subjects
- Adolescent, Adult, Aged, Female, Follow-Up Studies, France, Humans, Kidney Pelvis physiopathology, Male, Middle Aged, Retroperitoneal Space, Survival Rate, Treatment Outcome, Ureteral Obstruction diagnostic imaging, Ureteral Obstruction mortality, Urography, Urologic Surgical Procedures methods, Kidney Pelvis surgery, Laparoscopy methods, Ureteral Obstruction surgery
- Abstract
Purpose: We assessed the feasibility, reproducibility and morbidity of retroperitoneal laparoscopic pyeloplasty for ureteropelvic junction obstruction., Materials and Methods: A total of 55 retroperitoneal laparoscopic pyeloplasties were performed at 3 institutions between September 1996 and May 2000 in 33 women and 21 men. Results were analyzed in regard to radiological assessment by excretory urography at 3 months, complications and hospital stay., Results: We performed dismembered pyeloplasty in 48 cases and Fenger plasty in 7 cases. Crossing vessels were noted in 23 patients. The conversion rate was 5.4%. Mean operative time was 185 minutes (range 100 to 260), mean hospital stay was 4.5 days (range 1 to 14) and mean followup was 14.4 months (range 6 to 43.6). The overall complication rate was 12.7%. Complications in 7 patients included hematoma in 3, urinoma in 1, severe pyelonephritis in 1 and anastomotic stricture in 2 requiring open pyeloplasty at 3 weeks and delayed balloon incision at 13 months, respectively. Excretory urography in 50 patients and ultrasound in 4 showed decreased hydronephrosis in 88.9% at 3 months. Normal physical activity and absent pain were reported by 47 patients (87%) 1 month after surgery., Conclusions: Retroperitoneal laparoscopic pyeloplasty seems to be a valuable alternative to open pyeloplasty for ureteropelvic junction obstruction. The long-term outcome must be assessed before this procedure may be definitively validated.
- Published
- 2001