Laparoscopic <i>In Situ</i> Dismembered Pyeloplasty Can Facilitate Laparoscopic Ureteropelvic Junction Obstruction Repair: A Prospective Cohort Trial

Aminsharifi, Alireza; Molaie, Afshin; Monsef, Alireza

doi:10.1089/end.2017.0538

Cited by 3 publications

(5 citation statements)

References 11 publications

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“…12,13 CV was found in 17.18% of patients in our study and was seen predominantly on the left side and in female gender. Similarly, in Aminsharifi’ et al’s 14 study, 20 of 37 CV patients were girls, while 21 patients showed CV on the right side. In our study, patients without CVs presented more severe hydronephrosis than those with early diagnosis and mostly intrauterine diagnoses.…”

Section: Discussionmentioning

confidence: 68%

Our experience of operated pediatric ureteropelvic junction obstruction patients

et al. 2021

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Aims: Ureteropelvic junction obstruction (UPJO) may originate from extrinsic or intrinsic causes in children. The aim of this study is to present preoperative and postoperative data of our patients operated for UPJO. Methods: A total of 64 patients who underwent open pyeloplasty were investigated retrospectively. They were evaluated in terms of demographically, clinics, hydronephrosis, differential renal functions (DRFs), half-time tracer clearance (½TC), and histopathologic results. Patients’ numerical results were stated as mean ± standard deviation (SD). Results: Male gender was more prevalent ( n = 47, 73.4%) and mean age at surgery was 46.87 months. UPJO was located at the left side in 56.3% ( n = 36), and at the right side in 39.1% ( n = 25) of patients. It was bilateral in 4.7% ( n = 3). Hydronephrosis was found antenatally in 68.8% ( n = 44) of patients. The mean preoperative DRF was 49.7% (21–78%) and mean postoperative DRF was 49.2% (20–56%). Mean renal scintigraphic t1/2 was >20 min for all patients. The mean AP diameter was 21.58 mm (10–62 mm). Muscular hypertrophy was the most common pathological finding, mean length of excised segment was 10.26 mm (3–40 mm). Crossing vessel (CV) was detected in 17.18% ( n = 11). The CV was statistically associated with increased age of operation, left side, and female gender. Statistically significant hydronephrosis was found in non-CV patients. Re-operation was required in seven patients (7.8%). Conclusions: Intrinsic pathologies are more seen in the etiology of UPJO patients with antenatal diagnosis and this group needs operation at an earlier age. However, CV is found more commonly in patients who are diagnosed and operated at older ages.

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Section: Discussionmentioning

confidence: 68%

Our experience of operated pediatric ureteropelvic junction obstruction patients

et al. 2021

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“…The mean operative time for PUJ anastomosis was lesser in laparoscopic in situ pyeloplasty group. [ 14 ] This technique is similar to PAD technique described by Ahlawat et al . [ 9 ]…”

Section: Discussionmentioning

confidence: 99%

Techniques in minimally invasive transperitoneal pyeloplasty: A compilation

Mallikarjuna,

Ghouse,

Madduri

et al. 2023

Urology Annals

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Context: Minimally invasive management (laparoscopic/robot assisted) is currently the standard of care for managing pelvi ureteric junction obstruction (PUJO). Open techniques of management of PUJO are well described in literature. However, there appears to be relative lack of description of minimally invasive techniques in the literature. Objective: This article is aimed at describing in detail, with images, the various techniques and modifications in laparoscopic or robot-assisted management of PUJO. Evidence Acquisition: A review of literature on PubMed was performed and all articles which detailed any technique of minimally invasive pyeloplasty were included. Evidence Synthesis: The various techniques of minimally invasive pyeloplasty as well as the authors’ techniques are compiled and described in detail with intraoperative images. Conclusions: Operative techniques of minimally invasive pyeloplasty are not well described in literature. We have attempted to present a comprehensive resource of different techniques of minimally invasive pyeloplasty and the clinical scenarios in which they may be appropriate. This should prove to be a useful reference to the practicing urologist. Patient Summary: In this paper, we have compiled the various surgical techniques of treating obstruction at the PUJ of the kidney along with intraoperative photograph.

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“…Since then, a few pediatric large se- Conversion to open procedure 0 (8). However, while early series had reported anastomotic stenosis in babies (9,10), subsequent studies demonstrated feasibility irrespective of patient age and weight (6,7,(11)(12)(13). LP has been thought to be a technically challenging procedure in children.…”

Section: Discussionmentioning

confidence: 99%

“…Through laparoscopic view, the PUJ is seen in its real position, in contrast to the open or video assisted procedure which brings the PUJ outside, disrupting its normal anatomy. LP is thought to provide better identification to anomalous vessels and avoid twisting or bad positioning of the ureter ( 3 , 7 ).…”

Section: Discussionmentioning

confidence: 99%

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The outcomes of mini-laparoscopic pyeloplasty in children - brazilian experience

2020

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Objetive: Pelvicureteric junction (PUJ) obstruction is the main cause of hydronephrosis in childhood. Open pyeloplasty has been the gold standard treatment of this condition with success rate above 90%. The role of laparoscopic pyeloplasty (LP) in children is less well defi ned and has slowly emerged as an alternative procedure. We report outcomes of our initial experience with LP in 38 children from 2 months of age. Materials and Methods: From June 2015 to December 2017 38 children aged 2-60 months (mean age 1.7 years) underwent LP for correction of PUJ obstruction. The mean pre operative anteroposterior diameter of the renal pelvis (APD) was 43,5mm and all patients had hydronephrosis (APD 21.4-76 mm) and obstructed curve on diuretic renogram. Anderson-Hynes pyeloplasty was the performed technique. Results are reported. Results: Mean operative time was 107 minutes (70-180) with no conversion to open procedure. Pain control was needed mainly in the fi rst 12hs. Mean hospitalization was 2 days (1-5). There were complications in 5 children not affecting the fi nal outcome. Two patients had a re-obstruction requiring a second procedure with good result. The mean follow up was 18 months (13-36). The mean reduction on the postoperative APD was 41%-p<0,001 (end APD 5 to 41mm). Overall success rate was 94,7%. All children had good cosmetic results. Conclusions: This is a small series limited by short follow up, however its data suggest that LP has good functional and cosmetic results, not compromising the success of the open procedure, regardless patient age.

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Laparoscopic In Situ Dismembered Pyeloplasty Can Facilitate Laparoscopic Ureteropelvic Junction Obstruction Repair: A Prospective Cohort Trial

Abstract: Laparoscopic in situ pyeloplasty is a safe and effective approach that can help simplify laparoscopic pyeloplasty, especially at teaching centers where surgeons with variable levels of experience perform laparoscopic procedures.

Cited by 3 publications

References 11 publications

Our experience of operated pediatric ureteropelvic junction obstruction patients

Our experience of operated pediatric ureteropelvic junction obstruction patients

Techniques in minimally invasive transperitoneal pyeloplasty: A compilation

The outcomes of mini-laparoscopic pyeloplasty in children - brazilian experience

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