Ureteropelvic junction obstruction repair: when, how, what?

Tan, Beng Jit; Smith, Arthur D.

doi:10.1097/00042307-200403000-00002

Cited by 46 publications

(43 citation statements)

References 34 publications

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“…Preop, preoperative; Hb, hemoglobin a Significantly more patients needing pre-operative stents had continuing mild symptoms with normal renographic drainage post-operatively but, these patients had more pain pre-operatively As previously documented [6], our results for secondary pyeloplasty were inferior to those for a primary procedure (57% vs 98%). Despite the low morbidity of endoluminal treatments for PUJ obstruction, their overall success rate appears to be lower than for primary dismembered pyeloplasty [15]. Our data emphasize the importance of selecting a primary procedure with a proven high success rate.…”

Section: Discussionmentioning

confidence: 65%

Comparison of laparoscopic and open pyeloplasty in 100 patients with pelvi-ureteric junction obstruction

et al. 2007

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The efficacy of laparoscopic pyeloplasty is equivalent to that of open pyeloplasty, with less wound pain at 6 months. The outcome for secondary procedures is inferior. There was a trend toward a reduction in complications and the conversion rates with time, suggesting that there may be a learning curve of approximately 30 laparoscopic pyeloplasty cases. Preoperative stent insertion did not seem to affect any objective measures of outcome for laparoscopic pyeloplasty.

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Section: Discussionmentioning

confidence: 65%

Comparison of laparoscopic and open pyeloplasty in 100 patients with pelvi-ureteric junction obstruction

et al. 2007

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“…Additionally, injured crossing vessels can lead to significant hemorrhage [15]. In the setting of UPJ obstruction caused by an extrinsic crossing vessel, a surgical approach that includes dismembering the proximal ureter from the renal pelvis and reanastomosing the UPJ anterior to the crossing vessel is necessary to achieve optimal outcomes [16,17].…”

Section: Discussionmentioning

confidence: 99%

Pediatric ureteropelvic junction obstruction: can magnetic resonance urography identify crossing vessels?

et al. 2015

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“…Pyeloplasty is the gold standard treatment method for UPJ stenosis, with a success rate of % 90 7 The one important point is necessity of repeated balloon dilatations. We performed repeated balloon dilatation (3 times) to two patients.…”

Section: Discussionmentioning

confidence: 99%

Üst Üriner Trakt Rekonstrüksiyonu Sonrası Oluşan İyatrojenik Üreteral Darlıkların Balon Dilatasyonu

Duman¹,

Yıldırım²,

Akıllıoğlu³

et al. 2015

Cukurova Medical Journal

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Purpose: Open pyeloplasty is the gold standard treatment of uretero-pelvic junction (UPJ) stenosis. Although failure after open pyeloplasty or uretero-neosistosmy is not common, percutaneous or endoscopic interventions must be necessary in some cases. We present treatment of 6 pediatric patients by balloon dilatation after failed surgery. Material and Methods: Between 2008 and 2013 6 children were treated. Five patients had undergone open pyeloplasty for UP stenosis and, one has uretero-vesical anastomosis stricture after ureteroneosistostomy. Percutaneous antegrade balloon dilatation and double J stent placement were performed in three of six patients. In the other three patients retrograde endoscopic balloon dilatation and double J stent placement were performed. Results: Primary technical success was %50 and %100 for antegrade and retrograde approach respectively. Antegrade approach has failed in 3 patients (%50) and, retrograde approach and treatment were successful in all of these patients. Secondary and tertiary balloon dilatations were done through antegrade approach in 3 patients. Mean duration of double J stent was 114 days. As of today, five patients are followed smoothly. One patient who has UP stenosis underwent secondary open surgery. Conclusion: Balloon dilatation can be used safely in both antegrade and retrograde approaches because of lower profile of balloon catheters, so it could be considered as a first line treatment option after failed surgical treatment of upper urinary tract stenosis in children. Key words: UPJ stenosis, Balloon dilatation, Percutaneous, Pyeloplasty ÖZET Amaç: Üreteropelvik bileşke darlıklarının tedavisinde açık pyeloplasti altın standarttır. Üretero-neosistostomi ya da açık pyeloplasti sonrası başarısızlık nadir olmasına rağmen bazı vakalarda perkütan ya da endoskopik müdahaleler gerekli olabilir. Biz, 6 pediatrik hastanın başarısız acık cerrahi sonrası balon dilatasyonu ile tedavisini sunuyoruz. Materyal ve Metod: 2008 -2013 yılları arasında 6 çocuk hasta tedavi edildi. Beş hastada üreteropelvik darlık nedeniyle açık pyeloplasti sonrası, bir hastada ise üreteroneosistostomi sonrası gelişen üretero-vezikal anastomoz striktürü tespit edildi. Altı hastanın üç tanesine perkütan antegrad balon dilatasyonu uygulandı ve "Double J" stent yerleştirildi. Diğer üç hastaya retrograd endoskopik balon dilatasyon yapıldı ve "Double J" stent yerleştirildi. Bulgular: Primer teknik başarı antegrad ve retrograd yaklaşım için sırası ile % 50 ve % 100 idi. Antegrad yaklaşım 3 hastada (%50) başarısız oldu , retrograd yaklaşım ve tedavi tüm hastalarda başarılı oldu. Sekonder ve tersiyer balon dilatasyonlar üç hastada antegrad yaklaşımla yapıldı. "Double J" stentin ortalama kalma süresi 114 gün idi. Bugüne dek beş hastanın izlemi sorunsuz olarak devam etti. UP darlığı olan bir hasta sekonder açık cerrahiye gitti.

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Ureteropelvic junction obstruction repair: when, how, what?

Cited by 46 publications

References 34 publications

Comparison of laparoscopic and open pyeloplasty in 100 patients with pelvi-ureteric junction obstruction

Comparison of laparoscopic and open pyeloplasty in 100 patients with pelvi-ureteric junction obstruction

Pediatric ureteropelvic junction obstruction: can magnetic resonance urography identify crossing vessels?

Üst Üriner Trakt Rekonstrüksiyonu Sonrası Oluşan İyatrojenik Üreteral Darlıkların Balon Dilatasyonu

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