Korean J Urol.  2014 Oct;55(10):656-659. 10.4111/kju.2014.55.10.656.

Long-Term Follow-up Results of Laparoscopic Pyeloplasty

• Seo IY
• Oh TH
• Lee JW

• KMID: 2069788
• DOI: http://doi.org/10.4111/kju.2014.55.10.656

Abstract

PURPOSE
To assess the long-term follow-up results of laparoscopic pyeloplasty for ureteropelvic junction obstruction.
MATERIALS AND METHODS
Sixty-five patients (mean age, 43.8 years) who underwent standard laparoscopic pyeloplasty by transperitoneal approaches were enrolled in this study. The chief complaint was flank pain (n=57 patients); the remaining cases were detected incidentally. Twenty-three patients had undergone previous abdominal surgeries, including open pyeloplasty and endopyelotomy. Mean stricture length was 1.06 cm. Grade 3/4 and 4/4 hydronephrosis was detected in 36 and 14 patients, respectively. An obstructive pattern was present on the renal scan in 53 patients (81.5%).
RESULTS
Fifty-seven patients were treated with dismembered Anderson-Hynes pyeloplasty and eight patients with Fenger pyeloplasty. During the operation, crossing vessels were found in 27 patients (41.5%). Mean operating time was 159.42 minutes. Although there were no cases of open conversion, two patients with colon and spleen injuries were detected postoperatively. The mean starting time of postoperative ambulation and diet was 1.54 days and 1.86 days, respectively. Mean hospital stay was 8.09 days. Mean follow-up period was 36.5 months. Follow-up intravenous pyelography and renal scan showed improvements in 59 patients, and the radiologic success rate was 90.8%. Eight patients showed failure on radiologic or symptomatic evaluation, and the overall success rate was 87.7%. In the comparative analysis between the success and failure groups, drained amount was the only risk factor related to failure (554.41 mL. vs. 947.70 mL, p=0.024).
CONCLUSIONS
Long-term follow-up results support laparoscopic pyeloplasty as the standard treatment for ureteropelvic junction obstruction. Drained amount is a risk factor for failure of the operation.

Keyword

Laparoscopy; Treatment failure; Ureteral obstruction

MeSH Terms

Adolescent
Adult
Aged
Child
Female
Follow-Up Studies
Humans
Hydronephrosis/*congenital/pathology/surgery
Kidney Pelvis/surgery
Laparoscopy/adverse effects/methods
Male
Middle Aged
Multicystic Dysplastic Kidney/pathology/*surgery
Risk Factors
Severity of Illness Index
Treatment Failure
Treatment Outcome
Ureteral Obstruction/pathology/*surgery
Young Adult

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