Initial Complications and Late Results in Dismembered Pyeloplasty

Persky, Lester; Krause, James R.; Boltuch, Robert L.

doi:10.1016/s0022-5347(17)57936-7

Cited by 118 publications

(51 citation statements)

References 6 publications

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“…Since its description in 1949 by AndersonHynes, open dismembered pyeloplasty has been the gold standard for UPJ obstruction treatment, with success rates exceeding 90% (2). The lumbar incision adopted most of the time (lumbotomy), among other factors, leads to higher morbidity in the procedure, mainly related to the use of analgesics postoperatively and worse cosmetic effect besides a longer period of convalescence (6).…”

Section: Commentsmentioning

confidence: 99%

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Transperitoneal laparoscopic pyeloplasty: Brazilian initial experience with 55 cases

et al. 2010

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Purpose: To evaluate prospectively the results obtained in 55 patients undergoing laparoscopic pyeloplasty through transperitoneal access. Materials and Methods: From January 2005 to July 2009, fifty-five patients between 13 and 64 years old, were treated for ureteropelvic junction (UPJ) stenosis via a transperitoneal laparoscopy. All patients had clinical symptoms of high urinary obstruction and hydronephrosis confirmed by imaging methods. Anderson-Hynes dismembered pyeloplasty was performed in 51 patients and Fenger technique in the other 4 cases. Patients were clinically and imaging evaluated in the postoperative period at 3 and 6 months and then followed-up annually. Results: The operative time ranged from 95 to 270 min. The mean hospital stay was 2 days. The average blood loss was 170 mL. The time to return to normal activities ranged from 10 to 28 days. Anomalous vessels were identified in 27 patients, intrinsic stenosis in 23 patients and 5 patients had high implantation of the ureter. Laparoscopic pyelolithotomy was successfully performed in 6 patients with associated renal stones. That series monitoring ranged from 1 to 55 months. One patient had longer urinary fistula (11 days), 3 patients had portal infection and 6 patients had prolonged ileus. There was one conversion due to technical difficulties. From the later postoperative complications, 2 patients had re-stenosis, one determined by Anderson-Hynes technique and the other by Fenger technique. The success rate was 95.65%. Conclusions: Laparoscopic pyeloplasty has functional results comparable to conventional open technique. It offers less morbidity, with aesthetic and post-operative convalescence benefits and lower complication rates.

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Section: Commentsmentioning

confidence: 99%

“…The gold standard treatment of this pathology is Anderson-Hynes dismembered pyeloplasty, tradiClinical Urology doi: 10.1590/S1677-55382010000600005 tionally performed in a conventional open procedure, with success rates over 90% (2).…”

Section: Introductionmentioning

confidence: 99%

Transperitoneal laparoscopic pyeloplasty: Brazilian initial experience with 55 cases

et al. 2010

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“…Nevertheless, open surgery success rates in horseshoe kidneys were less favorable than in orthotopic kidneys, ranging from 55 to 80% (9,10) compared to over 90% respectively (11,12). In comparison, success rates of endopyelotomy in horseshoe kidneys range from 66-75% based on three small series, each containing just 3-4 patients (1,13,14).…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Pyeloplasty in Horseshoe Kidneys with Ureteropelvic Junction obstruction: A case series

et al. 2013

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Background and Purpose:Horseshoe kidney is an uncommon renal anomaly often associated with ureteropelvic junction (UPJ) obstruction. Advanced minimally invasive surgical (MIS) reconstructive techniques including laparoscopic and robotic surgery are now being utilized in this population. However, fewer than 30 cases of MIS UPJ reconstruction in horseshoe kidneys have been reported. We herein report our experience with these techniques in the largest series to date. Materials and Methods:We performed a retrospective chart review of nine patients with UPJ obstruction in horseshoe kidneys who underwent MIS repair at our institution between March 2000 and January 2012. Four underwent laparoscopic, two robotic, and one laparoendoscopic single-site (LESS) dismembered pyeloplasty. An additional two pediatric patients underwent robotic Hellstrom repair. Perioperative outcomes and treatment success were evaluated. Results: Median patient age was 18 years (range 2.5-62 years). Median operative time was 136 minutes (range 109-230 min.) and there were no perioperative complications. After a median follow-up of 11 months, clinical (symptomatic) success was 100%, while radiographic success based on MAG-3 renogram was 78%. The two failures were defined by prolonged t 1/2 drainage, but neither patient has required salvage therapy as they remain asymptomatic with stable differential renal function. Conclusions: MIS repair of UPJ obstruction in horseshoe kidneys is feasible and safe. Although excellent short-term clinical success is achieved, radiographic success may be lower than MIS pyeloplasty in heterotopic kidneys, possibly due to inherent differences in anatomy. Larger studies are needed to evaluate MIS pyeloplasty in this population.

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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: 31mentioning

confidence: 99%

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

Singh¹

2017

JMSCR

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Initial Complications and Late Results in Dismembered Pyeloplasty

Cited by 118 publications

References 6 publications

Transperitoneal laparoscopic pyeloplasty: Brazilian initial experience with 55 cases

Transperitoneal laparoscopic pyeloplasty: Brazilian initial experience with 55 cases

Minimally Invasive Pyeloplasty in Horseshoe Kidneys with Ureteropelvic Junction obstruction: A case series

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

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