ABSTRACT
Background@#An aim of this study was to evaluate the long-term functional outcomes of laparoscopic ureteropyeloplasty compared to that of open surgery at the Urology and Andrology Center of the First Central Hospital of Mongolia. Ureteropelvic junction (UPJ) is the most common site for upper urinary tract obstruction occurring 1 in 750 - 1500 births. Laparoscopic pyeloplasty was first reported in 1993 by Schuessler WW and its technique was dismembered pyeloplasty.@*Material and Methods@#In the period from June 2018 to September 2019, we have operated 91 ureteropyeloplasty cases. Patients were randomized into Group I (45 laparoscopy) operated by the laparoscopic ureteropyeloplasty and Group II (46 open surgery) operated by the open ureteropyeloplasty. All the patients had ureteropelvic junction obstruction and ureteropyeloplasty was performed. Both groups were compared according to the operative time, and recovery duration. We studied restoration of renal function and causes of conditions. Demographic data including age, gender and complications were recorded. Renal diethylenetriamine penta-acetate scintigraphy was respectively performed 6 months after surgery. @*Results@#Mean age was 32±12.05 ranging 16-62 in all the study population. A total of 91 (55 men and 36 women) were participated. Ureteropelvic junction stricture was occurred 75.66% in laparoscopic cases and 84.78% in open cases which leads to hydronephrosis and it was statistically different (p<0.028). Compared to that of open surgery, wound size was 6 time smaller, blood loss and hospital stay less than 2 fold and wound healing is 5 days shorter than open surgery. There was statistical different (p<0.001) between parameters of 2 groups. In laparoscopic and open group respectively, renal function was 41.78±10.02ml/min, 42.15±11.34 ml/min (1.73м2). After intervention, renal function was increased by (46±10.17ml/min, 46.09±11.50ml/min) and there was difference between 2 groups (p<0.003). In laparoscopic group, renal function was more improved than open group (p=0.05).@*Conclusion@#Laparoscopic surgery had less blood, less analgesics usage, fewer hospital stays, and faster wound healing. Renal function was improved 6 months after surgery.
ABSTRACT
PURPOSE: Because the preoperative diagnosis of xanthogranulomatous pyelonephritis (XGP) is difficult due to its similarities to other renal diseases, the diagnosis is made postoperatively in most patients. The aim of this study was to improve preoperative diagnosis of this disease. MATERIALS AND METHODS: We reviewed clinical characteristics, laboratory and radiological findings, preoperative diagnoses, and operative methods of 6 patients with XGP who underwent operation from March 1991 to July 1998. Mean age was 49.8 years (range 28 to 80) and male to female ratio was 1 to 2. RESULTS: All 6 patients had flank pain and urinary tract infection. Among 6 patients, there were 3 patients (50%) with renal staghorn stone and 1 (16.7%) with ureteropelvic junction stricture. No patient was diagnosed as XGP preoperatively. Three patients (50%) diagnosed as pyonephrosis with staghorn stone preopratively underwent simple nephrectomy and 2 patients diagnosed as renal mass preoperatively underwent radical nephrectomy. One patient diagnosed as renal abscess extended to retroperitoneum and psoas muscle preoperatively was diagnosed as XGP through intraoperative frozen section biopsy of renal tissue and underwent partial nephrectomy and drainage. CONCLUSIONS: Preoperative diagnosis of XGP will be raised through better understanding of the clinical characteristics and radiologic findings of this disease.
Subject(s)
Female , Humans , Male , Abscess , Biopsy , Constriction, Pathologic , Diagnosis , Drainage , Flank Pain , Frozen Sections , Nephrectomy , Psoas Muscles , Pyelonephritis, Xanthogranulomatous , Pyonephrosis , Urinary Tract InfectionsABSTRACT
Objectives:To evaluate the operative treatment for ureteropelvic junction(UPJ)stricture.Methods:A total of 58 cases of UPJ stricture had double-J tubes placed intraoperatively during Anderson-Hynes pyeloplasty.Urethral catheterization was maintained for 5~7 day,and the double-J tube was removed on cystoscopy 4 to 8 weeks after operation.The outcome was evaluated with ultrasonography or intravenous urography in 3 to 12 months postoperatively.Results:Success rate of management was 100%,stricture was relieved successfully in all patients,and hydronephrosis improved.Only 5 cases had complication in the near future.During follow-up of 6 months to 2 years,long-term complications,like stricture of the anastomotic mouth,and worsened kidney hydrocele,were not observed.all patients have been with satisfactory long-term results.Conclusions:Anderson-Hynes pyeloplasty was an effective method for the treatment of UPJ stricture.A double-J tubes in the operation could reduce the incidence of anastomotic mouth stricture and promote the success rate of operation.
ABSTRACT
A clinical observation was made on 10 patients with aberrant renal vessels who had been admitted to the Department of Urology, Ewha Woman's University Hospital during the period from Apr. 1976 to Sept. 1983. The following results were obtained. 1. Conservative treatment and periodical observation were done in 2 cases of aberrant renal vessels of both mild hydronephrosis with intermittent flank pain. 2. Left renal ptosis combined with moderate hydronephrosis revealed in I case of aberrant renal vessels, only nephropexy was done. 3. Right UPJ stricture combined with renal pelvis stone revealed in 1 case of aberrant renal vessels, right pyelolithotomy and nephropexy were done. 4. Horseshoe kidney combined with right renal pelvis stone was treated with isthmectomy, right pyelolithotomy and nephropexy in 1 case of aberrant renal vessels. 5. In 5 cases, RGP revealed UPJ stricture combined with marked hydronephrosis and aberrant renal vessels were discovered during operation. Dismembered pyeloplasty in 3 cases and nephrectomy in 2 cases of severe hydronephrosis were done.