Retroperitoneoscopic Pyeloplasty / 대한비뇨기과학회지

ABSTRACT

PURPOSE: To assess the feasibility and results of retroperitoneoscopic pyeloplasty in the treatment of ureteropelvic junction obstruction. MATERIALS AND METHODS: A total of 10 extraperitoneal laparoscopic pyeloplasties were performed for ureteropelvic junction obstructions. The patients were followed with excretory urographies. RESULTS: Two separate types of reconstruction were performed; 9 dismembered and 1 Fenger pyeloplasty. No cases resulted in an open conversion. The mean operating time was 294 minutes, ranging from 210 to 510 minutes. 3 patients were found to have aberrant vessels (30%). There were no intra-operative complications. The mean analgesic use and post-operative hospital stay were 328mg of diclofenac sodium, ranging from 150 to 450mg, and 4.3 days, ranging from 3 to 7 days, respectively. There were no post-operative complications, with the exception of 1 case of pain after the removal of double-J catheter. With the exception of 1 case that was lost during follow up, the average return to normal activity occurred in 2.6 weeks, ranging from 1 to 8 weeks. The excretory urographs, taken after 2 months, showed improvements in 6 of the 9 cases (67%), and of the remaining 3 cases, 2 showed an improvement over 6 months, and 1 over 12 months (total 9/9, 100%). The mean follow-up period was 18 months, ranging from 6 to 32 months, with no patient requiring further surgery. No pain was reported in 6 (6/9, 67%) of the cases and 3 cases reported a marked decrease in their pain (3/9, 33%). CONCLUSIONS: Retroperitoneoscopic pyeloplasty seems to be feasible and valuable alternative treatment for ureteropelvic junction obstruction, but a long term follow-up is required.