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High-pressure balloon assessment of pelviureteric junction prior to laparoscopic “vascular hitch”
AIM: To assess if calibration of the ureteropelvic junction (UPJ) using a high-pressure balloon inflated at the UPJ level in patients with suspected crossing vessels (CV) could differentiate between intrinsic and extrinsic stenosis prior to laparoscopic vascular hitch (VH). MATERIALS AND METHODS: We...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Sociedade Brasileira de Urologia
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4811241/ https://www.ncbi.nlm.nih.gov/pubmed/27136482 http://dx.doi.org/10.1590/S1677-5538.IBJU.2015.0343 |
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author | Parente, Alberto Angulo, José-María Romero, Rosa Burgos, Laura Ortiz, Rubén |
author_facet | Parente, Alberto Angulo, José-María Romero, Rosa Burgos, Laura Ortiz, Rubén |
author_sort | Parente, Alberto |
collection | PubMed |
description | AIM: To assess if calibration of the ureteropelvic junction (UPJ) using a high-pressure balloon inflated at the UPJ level in patients with suspected crossing vessels (CV) could differentiate between intrinsic and extrinsic stenosis prior to laparoscopic vascular hitch (VH). MATERIALS AND METHODS: We reviewed patients with UPJO diagnosed at childhood or adolescence without previous evidence of antenatal or infant hydronephrosis (10 patients). By cystoscopy, a high-pressure balloon is sited at the UPJ and the balloon inflated to 8-12 atm under radiological screening. We considered intrinsic PUJO to be present where a ‘waist’ was observed at the PUJ on inflation of the balloon and a laparoscopic dismembered pyeloplasty is performed When no ‘waist’ is observed we considered this to represent extrinsic stenosis and a laparoscopic VH was performed. Patients with absence of intrinsic PUJ stenosis documented with this method are included for the study. RESULTS: Six patients presented pure extrinsic stenosis. The mean age at presentation was 10.8 years. Mean duration of surgery was 99 min and mean hospital stay was 24 hours in all cases. We found no intraoperative or postoperative complications. All children remain symptoms free at a mean follow up of 14 months. Ultrasound and renogram improved in all cases. CONCLUSION: When no ‘waist’ is observed we considered this to represent extrinsic stenosis and a laparoscopic VH was performed. In these patients, laparoscopic transposition of lower pole crossing vessels (‘vascular hitch’) may be a safe and reliable surgical technique. |
format | Online Article Text |
id | pubmed-4811241 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Sociedade Brasileira de Urologia |
record_format | MEDLINE/PubMed |
spelling | pubmed-48112412016-05-09 High-pressure balloon assessment of pelviureteric junction prior to laparoscopic “vascular hitch” Parente, Alberto Angulo, José-María Romero, Rosa Burgos, Laura Ortiz, Rubén Int Braz J Urol Surgical Technique AIM: To assess if calibration of the ureteropelvic junction (UPJ) using a high-pressure balloon inflated at the UPJ level in patients with suspected crossing vessels (CV) could differentiate between intrinsic and extrinsic stenosis prior to laparoscopic vascular hitch (VH). MATERIALS AND METHODS: We reviewed patients with UPJO diagnosed at childhood or adolescence without previous evidence of antenatal or infant hydronephrosis (10 patients). By cystoscopy, a high-pressure balloon is sited at the UPJ and the balloon inflated to 8-12 atm under radiological screening. We considered intrinsic PUJO to be present where a ‘waist’ was observed at the PUJ on inflation of the balloon and a laparoscopic dismembered pyeloplasty is performed When no ‘waist’ is observed we considered this to represent extrinsic stenosis and a laparoscopic VH was performed. Patients with absence of intrinsic PUJ stenosis documented with this method are included for the study. RESULTS: Six patients presented pure extrinsic stenosis. The mean age at presentation was 10.8 years. Mean duration of surgery was 99 min and mean hospital stay was 24 hours in all cases. We found no intraoperative or postoperative complications. All children remain symptoms free at a mean follow up of 14 months. Ultrasound and renogram improved in all cases. CONCLUSION: When no ‘waist’ is observed we considered this to represent extrinsic stenosis and a laparoscopic VH was performed. In these patients, laparoscopic transposition of lower pole crossing vessels (‘vascular hitch’) may be a safe and reliable surgical technique. Sociedade Brasileira de Urologia 2016 /pmc/articles/PMC4811241/ /pubmed/27136482 http://dx.doi.org/10.1590/S1677-5538.IBJU.2015.0343 Text en http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Surgical Technique Parente, Alberto Angulo, José-María Romero, Rosa Burgos, Laura Ortiz, Rubén High-pressure balloon assessment of pelviureteric junction prior to laparoscopic “vascular hitch” |
title | High-pressure balloon assessment of pelviureteric junction prior to laparoscopic “vascular hitch” |
title_full | High-pressure balloon assessment of pelviureteric junction prior to laparoscopic “vascular hitch” |
title_fullStr | High-pressure balloon assessment of pelviureteric junction prior to laparoscopic “vascular hitch” |
title_full_unstemmed | High-pressure balloon assessment of pelviureteric junction prior to laparoscopic “vascular hitch” |
title_short | High-pressure balloon assessment of pelviureteric junction prior to laparoscopic “vascular hitch” |
title_sort | high-pressure balloon assessment of pelviureteric junction prior to laparoscopic “vascular hitch” |
topic | Surgical Technique |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4811241/ https://www.ncbi.nlm.nih.gov/pubmed/27136482 http://dx.doi.org/10.1590/S1677-5538.IBJU.2015.0343 |
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