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

OBJECTIVE: To evaluate the effect and safety of laparoscopic pyeloplasty in the treatment of pelvi-ureteric junction obstruction (PUJO). PATIENTS AND METHODS: In 34 patients, laparoscopic dismembered pyeloplasty was used to treat primary PUJO. Information was obtained for symptoms, results of a nucl...

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Detalles Bibliográficos
Autores principales: Nour, Hani, Mostafa, Ahmad, Gobashy, Samir, Elganzoury, Hossam, Elkholy, Amr, Riad, Essam
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4150588/
https://www.ncbi.nlm.nih.gov/pubmed/26579305
http://dx.doi.org/10.1016/j.aju.2011.10.005
Descripción
Sumario:OBJECTIVE: To evaluate the effect and safety of laparoscopic pyeloplasty in the treatment of pelvi-ureteric junction obstruction (PUJO). PATIENTS AND METHODS: In 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. RESULTS: The 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. CONCLUSION: Laparoscopic pyeloplasty is a safe and effective option which can produce satisfactory results both clinically and radiologically.