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Laparoscopic management of recurrent ureteropelvic junction obstruction following pyeloplasty.

Abraham GP, Siddaiah AT, Ramaswami K, George D, Das K - Urol Ann (2015 Apr-Jun)

Bottom Line: Transperitoneal approach was followed to repair the recurrent UPJO.Operative, postoperative, and follow-up functional details were recorded.Mean operative time was 191.25 ± 24.99 min, mean duration of hospital stay was 3.2 ± 0.45 days and mean follow-up duration was 29.9 ± 18.5 months with success rate of 93.3%.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Lakeshore Hospital and Research Centre, Kochi, Kerala, India.

ABSTRACT

Objective: The aim was to analyze the operative, postoperative and functional outcome of laparoscopic management of previously failed pyeloplasty and to compare operative and postoperative outcome with laparoscopic pyeloplasty for primary ureteropelvic junction obstruction (UPJO).

Materials and methods: All patients who underwent laparoscopic management for previously failed dismembered pyeloplasty were analyzed in this study. Detailed clinical and imaging evaluation was performed. Transperitoneal approach was followed to repair the recurrent UPJO. Operative, postoperative, and follow-up functional details were recorded. Operative and postoperative outcomes of laparoscopic redo pyeloplasty were compared with that of laparoscopic primary pyeloplasty.

Results: A total of 16 patients were managed with laparoscopic approach for previously failed pyeloplasty. Primary surgical approach for dismembered pyeloplasty was open in 11, laparoscopy in four patients and robotic assisted in one patient. Fifteen were treated with redo pyeloplasty and one with ureterocalicostomy. Mean operative time was 191.25 ± 24.99 min, mean duration of hospital stay was 3.2 ± 0.45 days and mean follow-up duration was 29.9 ± 18.5 months with success rate of 93.3%. Operative time was significantly prolonged with redo pyeloplasty group compared with primary pyeloplasty group (191.25 ± 24.99 vs. 145 ± 22.89, P = 0.0001).

Conclusion: Laparoscopic redo pyeloplasty is a viable option with a satisfactory outcome and less morbidity.

No MeSH data available.


Related in: MedlinePlus

Intravenous urography showing gross right hydronephrosis following a failed open pyeloplasty
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Figure 1: Intravenous urography showing gross right hydronephrosis following a failed open pyeloplasty

Mentions: All patients who underwent laparoscopic management of previously failed pyeloplasty at our center were included in this retrospective study. Patient's data and previous surgery details were collected. All patients underwent detailed evaluation in the form of computed tomography/magnetic resonance/intravenous urography, [Figures 1 and 2] diethylenetriamine pentaacetic acid (DTPA) renogram and retrograde pyelography. Patients with salvageable renal units underwent laparoscopic redo Pyeloplasty. All patients were operated by single surgeon George P Abraham. The operative and postoperative details were collected. Patients were followed up at regular interval with clinical assessment, ultrasonography and DTPA renogram. Failure is defined as persistence or recurrence of symptoms and obstructive drainage pattern in DTPA renogram. A comparative analysis was performed between patients who underwent laparoscopic redo pyeloplasty and recent 75 patients who underwent laparoscopic pyeloplasty for primary UPJO for operative and postoperative outcome. Statistical analysis was performed using SAS version 9.2 software (SAS institute, NC, USA). P <0.05 is considered to be statistically significant.


Laparoscopic management of recurrent ureteropelvic junction obstruction following pyeloplasty.

Abraham GP, Siddaiah AT, Ramaswami K, George D, Das K - Urol Ann (2015 Apr-Jun)

Intravenous urography showing gross right hydronephrosis following a failed open pyeloplasty
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4374256&req=5

Figure 1: Intravenous urography showing gross right hydronephrosis following a failed open pyeloplasty
Mentions: All patients who underwent laparoscopic management of previously failed pyeloplasty at our center were included in this retrospective study. Patient's data and previous surgery details were collected. All patients underwent detailed evaluation in the form of computed tomography/magnetic resonance/intravenous urography, [Figures 1 and 2] diethylenetriamine pentaacetic acid (DTPA) renogram and retrograde pyelography. Patients with salvageable renal units underwent laparoscopic redo Pyeloplasty. All patients were operated by single surgeon George P Abraham. The operative and postoperative details were collected. Patients were followed up at regular interval with clinical assessment, ultrasonography and DTPA renogram. Failure is defined as persistence or recurrence of symptoms and obstructive drainage pattern in DTPA renogram. A comparative analysis was performed between patients who underwent laparoscopic redo pyeloplasty and recent 75 patients who underwent laparoscopic pyeloplasty for primary UPJO for operative and postoperative outcome. Statistical analysis was performed using SAS version 9.2 software (SAS institute, NC, USA). P <0.05 is considered to be statistically significant.

Bottom Line: Transperitoneal approach was followed to repair the recurrent UPJO.Operative, postoperative, and follow-up functional details were recorded.Mean operative time was 191.25 ± 24.99 min, mean duration of hospital stay was 3.2 ± 0.45 days and mean follow-up duration was 29.9 ± 18.5 months with success rate of 93.3%.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Lakeshore Hospital and Research Centre, Kochi, Kerala, India.

ABSTRACT

Objective: The aim was to analyze the operative, postoperative and functional outcome of laparoscopic management of previously failed pyeloplasty and to compare operative and postoperative outcome with laparoscopic pyeloplasty for primary ureteropelvic junction obstruction (UPJO).

Materials and methods: All patients who underwent laparoscopic management for previously failed dismembered pyeloplasty were analyzed in this study. Detailed clinical and imaging evaluation was performed. Transperitoneal approach was followed to repair the recurrent UPJO. Operative, postoperative, and follow-up functional details were recorded. Operative and postoperative outcomes of laparoscopic redo pyeloplasty were compared with that of laparoscopic primary pyeloplasty.

Results: A total of 16 patients were managed with laparoscopic approach for previously failed pyeloplasty. Primary surgical approach for dismembered pyeloplasty was open in 11, laparoscopy in four patients and robotic assisted in one patient. Fifteen were treated with redo pyeloplasty and one with ureterocalicostomy. Mean operative time was 191.25 ± 24.99 min, mean duration of hospital stay was 3.2 ± 0.45 days and mean follow-up duration was 29.9 ± 18.5 months with success rate of 93.3%. Operative time was significantly prolonged with redo pyeloplasty group compared with primary pyeloplasty group (191.25 ± 24.99 vs. 145 ± 22.89, P = 0.0001).

Conclusion: Laparoscopic redo pyeloplasty is a viable option with a satisfactory outcome and less morbidity.

No MeSH data available.


Related in: MedlinePlus