Laparoscopic pyeloplasty: experience with the initial 30 cases.

R G Moore; T D Averch; P G Schulam; J B Adams; R N Chen; L R Kavoussi

doi:10.1016/s0022-5347(01)65170-x

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Laparoscopic pyeloplasty: experience with the initial 30 cases.

R G Moore·T D Averch·P G Schulam·J B Adams·R N Chen·L R Kavoussi

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Abstract

PURPOSE: We assessed the intermediate effectiveness of laparoscopic pyeloplasty in the treatment of the obstructed ureteropelvic junction. MATERIALS AND METHODS: A total of 30 pyeloplasties was performed for symptomatic ureteropelvic junction obstruction (24 primary and 6 secondary cases). Two separate types of reconstruction were performed, that is dismembered (26 patients) and Y-V (4) pyeloplasty. All patients were followed with excretory urography or diuretic renography. Moreover, factors affecting the learning curve (surgical technique, prior laparoscopic experience and cause of obstruction) were evaluated. RESULTS: A lower pole segmental renal vessel was found at the ureteropelvic junction in 18 patients (60%). Operative time ranged from 2.25 to 8.0 hours (mean 4.5). Postoperative morbidity (mean narcotic requirement 37.3 mg. morphine sulfate, mean hospital stay 3.5 days and convalescence 3 weeks) was minimum. At radiographic followup (mean 16.3 months, range 4 to 73) 97% of the patients demonstrated a patent ureteropelvic junction and resolution of or substantial decrease in hydronephrosis. CONCLUSIONS: In the hands of an experienced laparoscopist, outcomes indicate that laparoscopic pyeloplasty shows success similar to that of open pyeloplasty but longer term outcomes must be assessed.

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Female Follow-Up Studies Humans Kidney Pelvis Laparoscopy Male Ureteral Obstruction Clinical Trial Journal Article

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R G Moore, T D Averch, P G Schulam, J B Adams, R N Chen, L R Kavoussi. 1997. Laparoscopic pyeloplasty: experience with the initial 30 cases.. https://doi.org/10.1016/s0022-5347(01)65170-x

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