Follow-up and complication analysis of the single-port transumbilical laparoscopic pyeloureteroplasty / 中华泌尿外科杂志

ABSTRACT

Objective To summarize the complications of the single-port transumbilical laparoscopic pyeloureteroplasty.Methods From August 2009 to December 2014, 162 surgical procedures were performed in our institute with the single-port transumbilical laparoscopic pyeloureteroplasty.Medical records of each procedure were retrospectively evaluated.139 patients were male and 23 female, aged from 1 month to 14 years and the median age of 2 years.127 patients were operated on the left side and 32 on the right side.3 patients were operated on the bilateral side.All children were supplemented with preoperative ultrasound, renal dynamic imaging and MRU to identify the ureteropelvic junction obstruction.Intraoperative and postoperative complications were graded according to the Satava and Clavien classifications respectively.Major complications were defined as Satava grade Ⅱ or higher, and Clavien grade Ⅲ or higher.Results There was no injury of vascular or visceral organs and no blood transfusion, and there was no serious intraoperative complications.One hundred and forty-three cases were followed up, and 23 cases (16.1％)presented with postoperative fever (＞ 38 ℃C) (Clavien Ⅰ), 2 cases (1.4％) with urinary extravasation diagnosed by perirenal fluid collection(Clavien Ⅰ).All these cases recovered after being given symptomatic treatment.7 cases (4.9％) presented with postoperative repeated urinary infection (Clavien Ⅱ).5 cases received postoperative reoperation due to the obstruction of the anastomic site (Clavien Ⅲ b), and 2 cases were under debridement as the greater omentum was drawn out along with the negative pressure drainage tube(Clavien Ⅲ a).In summary, the incidence of severe postoperative complications was 4.9％.Conclusions Though there existed some postoperative complications of the single-port transumbilical laparoscopic pyeloureteroplasty, the incidence of serious complications was low and the overall prognosis could be good.