Laparoscopic dismembered pyeloplasty in 47 cases

PURPOSE: To evaluate the results of a sequence of 47 laparoscopic Anderson-Hynes pyeloplasties for the treatment of patients with ureteropelvic junction obstruction, independently of the etiology. MATERIALS AND METHODS: Twenty male and 27 female patients diagnosed with ureteropelvic junction obstruc...

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Main Authors: Anuar Ibrahim Mitre, Artur Henrique Brito, Miguel Srougi
Format: Article
Language:English
Published: Elsevier España 2008-01-01
Series:Clinics
Subjects:
Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322008000500011
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author Anuar Ibrahim Mitre
Artur Henrique Brito
Miguel Srougi
author_facet Anuar Ibrahim Mitre
Artur Henrique Brito
Miguel Srougi
author_sort Anuar Ibrahim Mitre
collection DOAJ
description PURPOSE: To evaluate the results of a sequence of 47 laparoscopic Anderson-Hynes pyeloplasties for the treatment of patients with ureteropelvic junction obstruction, independently of the etiology. MATERIALS AND METHODS: Twenty male and 27 female patients diagnosed with ureteropelvic junction obstruction were treated by Anderson-Hynes transperitoneal laparoscopic dismembered pyeloplasty from April 2002 to January 2006. The age of the patients ranged from four to 75 years, with a mean age of 32.3 years. The follow-up ranged between six and 30 months, with a mean follow-up time of 24 months. The outcomes were evaluated through the assessment of symptoms and imaging studies. RESULTS: In 44 (93.6%) of the 47 patients, resolution of the pain and a reduction in ureteropelvic dilation were observed. The mean operative time was 157 minutes (ranging from 90 to 270 minutes). Neither blood transfusion nor conversion to open surgery was required. The mean hospital stay was 2.2 days. The presence of crossing vessels over the ureteropelvic junction was verified in 26 patients (55%), and vessel transposition in relation to the urinary tract was performed in 25 of these cases. In one patient, the crossing vessel was mobilized out of the ureteropelvic junction with a perivascular suture to the renal capsule associated with the pyeloplasty. CONCLUSIONS: The outcome of transperitoneal Anderson-Hynes laparoscopic pyeloplasty used for different causes of pyeloureteral obstruction presented a success rate similar to a previously-published open procedure, with the advantage of being less invasive. This procedure may be considered the first option for the treatment of ureteropelvic junction obstruction.
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spelling doaj.art-aade25292d58419782825153d4bf6f982022-12-22T02:46:42ZengElsevier EspañaClinics1807-59321980-53222008-01-0163563163610.1590/S1807-59322008000500011Laparoscopic dismembered pyeloplasty in 47 casesAnuar Ibrahim MitreArtur Henrique BritoMiguel SrougiPURPOSE: To evaluate the results of a sequence of 47 laparoscopic Anderson-Hynes pyeloplasties for the treatment of patients with ureteropelvic junction obstruction, independently of the etiology. MATERIALS AND METHODS: Twenty male and 27 female patients diagnosed with ureteropelvic junction obstruction were treated by Anderson-Hynes transperitoneal laparoscopic dismembered pyeloplasty from April 2002 to January 2006. The age of the patients ranged from four to 75 years, with a mean age of 32.3 years. The follow-up ranged between six and 30 months, with a mean follow-up time of 24 months. The outcomes were evaluated through the assessment of symptoms and imaging studies. RESULTS: In 44 (93.6%) of the 47 patients, resolution of the pain and a reduction in ureteropelvic dilation were observed. The mean operative time was 157 minutes (ranging from 90 to 270 minutes). Neither blood transfusion nor conversion to open surgery was required. The mean hospital stay was 2.2 days. The presence of crossing vessels over the ureteropelvic junction was verified in 26 patients (55%), and vessel transposition in relation to the urinary tract was performed in 25 of these cases. In one patient, the crossing vessel was mobilized out of the ureteropelvic junction with a perivascular suture to the renal capsule associated with the pyeloplasty. CONCLUSIONS: The outcome of transperitoneal Anderson-Hynes laparoscopic pyeloplasty used for different causes of pyeloureteral obstruction presented a success rate similar to a previously-published open procedure, with the advantage of being less invasive. This procedure may be considered the first option for the treatment of ureteropelvic junction obstruction.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322008000500011Laparoscopyureteral obstructionHydronephrosisUrinary tract anomaliesUreteropelvic junction obstruction
spellingShingle Anuar Ibrahim Mitre
Artur Henrique Brito
Miguel Srougi
Laparoscopic dismembered pyeloplasty in 47 cases
Clinics
Laparoscopy
ureteral obstruction
Hydronephrosis
Urinary tract anomalies
Ureteropelvic junction obstruction
title Laparoscopic dismembered pyeloplasty in 47 cases
title_full Laparoscopic dismembered pyeloplasty in 47 cases
title_fullStr Laparoscopic dismembered pyeloplasty in 47 cases
title_full_unstemmed Laparoscopic dismembered pyeloplasty in 47 cases
title_short Laparoscopic dismembered pyeloplasty in 47 cases
title_sort laparoscopic dismembered pyeloplasty in 47 cases
topic Laparoscopy
ureteral obstruction
Hydronephrosis
Urinary tract anomalies
Ureteropelvic junction obstruction
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322008000500011
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