Adult Endopyelotomy: Impact of Etiology and Antegrade Versus Retrograde Approach on Outcome

Shalhav, Arieh L.; Giusti, Guido; Elbahnasy, Abdelhamid M.; Hoenig, David M.; McDougall, Elspeth M.; Smith, Deborah S.; Maxwell, Keegan L.; Clayman, Ralph V.

doi:10.1016/s0022-5347(01)62755-1

Cited by 75 publications

(29 citation statements)

References 10 publications

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“…13,14,32,33 Similarly success rates of endopyelotomy in horseshoe kidneys range from 66-75% compared to rates in orthotopic kidneys, which range from 77 to 89% with absent crossing vessels, and less than 70% in the presence of a crossing vessel. 20,21,[34][35][36] The overall radiographic success rate of 78% is thus comparable to success rates reported for open pyeloplasty in horseshoe kidneys.…”

Section: 31supporting

confidence: 60%

The Morphology and Treatment of Coexisting Pelvi-Ureteric Junction Obstruction In Horseshoe Kidney

Singh¹

2017

JMSCR

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Section: 31supporting

confidence: 60%

The Morphology and Treatment of Coexisting Pelvi-Ureteric Junction Obstruction In Horseshoe Kidney

Singh¹

2017

JMSCR

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“…15 The 2 most common retrograde approaches are hot-wire balloon endopyelotomy and holmium laser endopyelotomy. Success rates are comparable between the 2 retrograde techniques, although holmium laser endopyelotomy is associated with fewer hemorrhagic complications in one series.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic pyeloplasty: the updated McMaster University experience

Dong

Wong

Alenezi

et al. 2013

CUAJ

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Objective: The open Anderson-Hynes procedure has an overall success rate of 90% for ureteropelvic junction obstruction. Laparoscopic pyeloplasty (LP) was developed to reduce morbidity and hospital stay while preserving the excellent results. We report on the results of our experience with laparoscopic pyeloplasty. Diuretic renal scan and U/S or IVP were performed at 6 months, and subsequent follow-up included a U/S or IVP as well as clinical assessment. Patients were assessed for pain and hydronephrosis on radiologic imaging, clearance on diuretic renal scan (T 1/2 ) and differential renal function. Methods: Results:We evaluated 73 patients. The mean patient age was 38 years (range 16-71 yr), the mean operating time was 218 minutes (range 110-409 min), and the mean blood loss was 57 mL (range 25-250 mL). Mean hospital stay was 3.0 days (range 2-7 d). The success rate was 90.4%, and failures were mainly due to poor function after surgery (3 patients). Pyelolithotomy was performed concomitantly on 6 patients, which on average extended operative time by 36 minutes. Conclusion:Our success rates are consistent with the LP experience of other centres and are comparable with rates for the open technique. Patients had short hospital stays, and complications were negligible. With experienced surgeons, LP should be the first-line treatment for ureteropelvic junction obstruction.

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“…However, the success rates of these minimally invasive endoscopic techniques (antegrade percutaneous endopyelotomy, retrograde endopyelotomy, and Accucise balloon) are approximately 10-25% lower than those of open pyeloplasty, and hemorrhagic complications are more frequent. [4][5][6][7][8][9] Moreover, these techniques cannot be applied universally to all patients, such as those with pelvic volumes of > 70 mL, renal function < 30%, or who have a crossing vessel. Furthermore, crossing vessels can be missed by radiographic imaging and discovered only during surgical exploration after the incisional procedure fails.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] However, it is associated with open surgery postoperative morbidity, pain, prolonged convalescence and a prominent skin incision. Various minimally invasive techniques for repairing obstructed UPJ, such as percutaneous antegrade and endoscopic retrograde approaches, have success rates that are 10-25% lower than those of open pyeloplasty [4][5][6][7][8][9] and are not suitable for patients with a large renal pelvis, poor renal function, high insertion of ureter, concomitant renal stones, extrinsic vessels, or for patients who have failed endourologic procedures.…”

Section: Introductionmentioning

confidence: 99%

Cost‐effective laparoscopic pyeloplasty: Single center experience

Hemal

Goel

2003

Int J of Urology

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SummaryObjective : Laparoscopic pyeloplasty (LPP) is a minimally invasive treatment option for ureteropelvic junction (UPJ) obstruction. We report here our experience of performing cost-effective LPP on 24 patients at a single center. Methods : Between October 1999 and March 2002, LPP was performed in 24 patients (17 male, seven female; age range 8-51 years) including two patients who had failed previous endourologic treatments. In two patients with concomitant renal stones, laparoscopic pyelolithotomy was also performed. LPP was conducted in a cost-reductive manner by both transperitoneal ( n = 12) and retroperitoneal ( n = 12) access. To reduce the cost, an indigenous balloon to create the retroperitoneal space, reusable ports, ordinary polyglactin suture and intracorporeal free-hand suturing were employed. To reduce operative time, antegrade stenting was also performed in some cases.Results : Laparoscopic Anderson-Hynes pyeloplasty was performed in 16, Foley Y-V pyeloplasty in five and Fenger pyeloplasty in three patients. One patient required conversion to open surgery due to tension at the anastomosis site during Anderson-Hynes pyeloplasty. The mean operating time, blood loss, analgesic (pethidine) requirement, duration of drain and hospital stay for the retroperitoneal and transperitoneal groups were 170.3 and 187.6 min, 102.2 and 145.9 mL, 125 and 136.4 mg, 2.1 and 2.5 days, and 3.4 and 4.3 days, respectively. No significant complications were encountered apart from prolonged ileus in three patients in the transperitoneal group. The mean follow-up period was 10.8 months with a range of 2-24 months. Postoperative renal scan was performed at 3 months in 21 patients, and 1 year in 11 patients. There was evidence of equivocal obstruction in one patient, but there were no obstructions in the remaining patients. Conclusion

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Adult Endopyelotomy: Impact of Etiology and Antegrade Versus Retrograde Approach on Outcome

Cited by 75 publications

References 10 publications

The Morphology and Treatment of Coexisting Pelvi-Ureteric Junction Obstruction In Horseshoe Kidney

The Morphology and Treatment of Coexisting Pelvi-Ureteric Junction Obstruction In Horseshoe Kidney

Laparoscopic pyeloplasty: the updated McMaster University experience

Cost‐effective laparoscopic pyeloplasty: Single center experience

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