Surgical options in the management of ureteropelvic junction obstruction

Sutherland, D. E.; Jarrett, Thomas W.

doi:10.1007/s11934-009-0006-y

Cited by 9 publications

(7 citation statements)

References 37 publications

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“…However, the technological advances allowed more and more minimally invasive techniques to be used to treat UPJO, including endoscopic treatment and laparoscopic treatment. Compared with OP, these minimally invasive treatments have the advantages of shorter recovery time, shorter hospital stay, and better cosmetic results [2,3,9]. The endoscopic treatment is promising at first, but the long-term success rates are lower than those of OP [8], especially for the patients with crossing vessel [10] or with large extrarenal pelvis [11].…”

Section: Discussionmentioning

confidence: 99%

“…Since reported by Anderson and Hynes in 1949 [1], open dismembered pyeloplasty has been used to treat UPJO and been regarded as gold standard treatment for UPJO [2]. With the development of minimally invasive techniques, laparoscopic pyeloplasty (LP) and robot-assisted pyeloplasty (RLP) gradually replaced open pyeloplasty (OP), with the similar success rates [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

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Head-to-Head Comparison of Modified Laparoscopic Pyeloplasty and Robot-Assisted Pyeloplasty for Ureteropelvic Junction Obstruction in China

et al. 2018

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Objective: To compare the outcomes of modified laparoscopic pyeloplasty (LP) and robot-assisted pyeloplasty (RLP) for ureteropelvic junction obstruction (UPJO) in China patients. Materials and Methods: We retrospectively reviewed the medical records of patients who underwent modified LP and RLP using a transperitoneal laparoscopic approach at 2 different medical institutions between October 2009 and November 2017. Results: Seventy-six patients underwent modified LP and 140 patients underwent RLP. No open conversion occurred. The mean operative time of RLP was shorter than that of modified LP (p = 0.042). For UPJO concomitant with renal calculi, there was no difference in operative time between 2 groups (p = 0.656). With RLP, the operative time for UPJO concomitant with horseshoe was shorter (p = 0.011). In terms of complication rate, there was no significant difference between 2 groups (p = 0.596). The postoperative hospital stay for modified LP was shorter than that for RLP (p < 0.05). The mean follow-up time for modified LP and RLP was 31.79 months and 10.85 months respectively (p < 0.05). The success rate was 96.05 and 97.86% for modified LP and RLP, respectively (p = 0.736). Conclusions: Modified LP and RLP are safe and efficient treatment for UPJO with similar success rates.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Head-to-Head Comparison of Modified Laparoscopic Pyeloplasty and Robot-Assisted Pyeloplasty for Ureteropelvic Junction Obstruction in China

et al. 2018

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“…Manifestations can vary from being asymptomatic to presenting with signs and symptoms like recurrent urinary tract infections, renal stones and pain 2. With the help of prenatal screening ultrasonography, hydronephrosis is detected with a prevalence of 0.5% to 1% 3,4.…”

Section: Introductionmentioning

confidence: 99%

“…Indications for surgical intervention include differential function less than 40% which is evaluated by isotopic studies, anterior-posterior (AP) diameter of renal pelvic greater than 20mm, grade III or IV dilatation, pain and infection, and also failure of conservative management leading to more than 10% loss of renal function 1. It should be noted that surgical corrections are not always mandatory 2. The most important part is preservation of renal function, which for up to 20% of patients requires early interventions, while others can be followed for spontaneous resolution or observation for necessity of treatment at a later time 3.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Caspase 3 Enzyme and TNF-alpha as Biomarkers in Ureteropelvic Junction Obstruction in Children- a preliminary report

et al. 2017

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Objective:To determine the applicability of urinary caspase 3 enzyme and TNF-α as biomarkers in children with ureteropelvic junction obstruction (UPJO).Methods:In this study, 31 unilateral UPJO patients and 33 age- and sex-matched healthy childrens were enrolled. The patients with UPJO consisted of 11 female and 20 male children between the ages of 2 to 62 months old. All participants were evaluated regarding anterior-posterior(AP) diameter and cortical thickness of affected kidney by ultrasonography. Technetium DTPA renal scan and voiding cystourethrogram(to assess vesicoureteral reflux) were performed, pre-operatively. Also, urinary levels of TNF-α and caspase 3 enzyme were checked. Follow-ups included measurement of aforementioned indices in patients: AP diameter and cortical thickness of the affected kidney, as well as TNF-α and caspase 3 levels in urine, three and six months after pyeloplasty.Results:The results showed highly significant decrease in urinary TNF-α and caspase 3 enzyme (P values < 0.01), approaching the level measured in children without UPJO after six months. Significant decrease in AP diameter and increase in cortical thickness were also noticed (P values < 0.01).Conclusion:The results of this study strongly support that TNF-α and caspase 3 levels in urine can be used for improvement monitoring in follow-up of UPJO patients after pyeloplasty and can also be potentially used as determining indices for surgical plan but more studies, especially in patients who are not surgical candidates are needed to confirm our observaitons.

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“…Traditionally, treatment of UPJO was based on surgical open pyeloplasty [2]. Anderson and Hynes open pyeloplasty consists mainly of the ablation of the ureteral stenosed segment, the removal of part of the dilated pelvis and the performance of a ureteral muco–mucosal anastomosis.…”

Section: Introductionmentioning

confidence: 99%

Renal function recovery after laparosocopic pyeloplasty

Rivas

Gregorio

Eastmond

et al. 2014

CEJU

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IntroductionTo observe the renal function recovery measured by diuretic renography in short and medium follow–up of patients with transperitoneal Anderson–Hynes laparoscopic pyeloplasty.Material and methodsWe performed a retrospective review from our series of laparoscopic pyeloplasties, and we applied the following selection criteria: 1) to have at least two MAG3 diuretic renography during the follow–up, performed with a gap of 4–6 months between them; 2) to have at least one year follow–up. Fulfilling these criteria, we have selected 35 patents of 62.ResultsDuring follow–up, statistically significant improvement comparing with the pre–surgical value has been observed in diuretic renography in the operated kidney in all selected patients during the time of follow up in terms of: functional uptake ratio (FUR), furosemide excretion and total excretion. No statistically significant differences were found in excretion time and spontaneous excretion parameters. By dividing patients in two age groups <40 years and >40 years we found no statistically significant differences between them in relation to the improvement of the FUR.ConclusionsLaparoscopic pyeloplasty not only corrects the UPJO, it also may recover renal function demonstrated after one year follow up with diuretic renography. Laparoscopic pyeloplasty should be procedure of choice even in those patients with poor renal function at diagnosis, whenever there are chances of recovering renal function, regardless patients age.

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Surgical options in the management of ureteropelvic junction obstruction

Cited by 9 publications

References 37 publications

Head-to-Head Comparison of Modified Laparoscopic Pyeloplasty and Robot-Assisted Pyeloplasty for Ureteropelvic Junction Obstruction in China

Head-to-Head Comparison of Modified Laparoscopic Pyeloplasty and Robot-Assisted Pyeloplasty for Ureteropelvic Junction Obstruction in China

Evaluation of Caspase 3 Enzyme and TNF-alpha as Biomarkers in Ureteropelvic Junction Obstruction in Children- a preliminary report

Renal function recovery after laparosocopic pyeloplasty

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