The application of laparoscopy in kidney preserving surgery for the treatment of savage giant hydro-nephrosis / 中华泌尿外科杂志

ABSTRACT

Objective To evaluate the application and initial experience of laparoscopy in kidneypreserving surgery for savage giant hydronephrosis. Methods This series included 6 cases of savage gianthydronephrosis (2 men and 4 women;age range,15 -57 years;mean age,28 years).Of them 5 cases weredetected when visiting doctors due to flank pain,abdominal mass,and the rest one by B-ultrasound duringpregnancy.Four cases had hydronephrosis on the left;and 2 cases,on the right.The quantity of hydronephro-sis was 2250 -8300 ml,respectively.None had development on IVU examination.Of them,3 cases had con-genital ureteropelvic junction (UPJ) obstruction;2 had multiple stones in infracalices secondary to UPJ ob-struction;1 had stones in pelvis with polyp formation.Relieving obstruction,pyeloplasty,nephroplication andnephropexy were performed via laparoscope. Results All the operations were successful.The operativetime was 2.5 -5.0 h;the blood loss was 50 -150 ml,and the mean postoperative hospital stay was 7.2 d.The postoperative follow-up ranged from 3 to 24 months. Three months after operation,B-ultrasound showedthat giant hydronephrosis was markedly relieved in 5 cases (the renal sinus separation was 1.8 m,2.0 cm,2.5 cm,2.5 cm and 2.8cm,respectively),and in the rest 1 case the kidney was slightly smaller than nor-mal.IVU examination was performed every 3 months after operation, and different degrees of developmentappeared in all cases.During the follow-up,no obvious ureteropelvic anastomotic stricture was found on retro-grade pyelography (RGP). Conclusions The protective renal treatment via laparoscopy for savage gianthydronephrosis is a feasible and minimally invasive technique that provides the same clinical and radiograph-ic results as open operation.