Laparoscopic ureterolysis and omental wrapping in patients with retroperitoneal fibrosis and obstructive uropathy: a single-center experience
| Autor: | Qutub Ali, Onkar Singh, Shilpi Singh Gupta, Nand Kishore Arvind, Surbhi Sahay, Janak Singh |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Intraoperative Complication Urethral Obstruction Ureterolysis Retroperitoneal fibrosis Single Center Postoperative Complications medicine Humans In patient Prospective Studies Intraoperative Complications Obstructive uropathy Retrospective Studies business.industry Postoperative complication Retroperitoneal Fibrosis Middle Aged medicine.disease Surgery Operative time Female Laparoscopy medicine.symptom business Omentum Follow-Up Studies |
| Zdroj: | Journal of laparoendoscopicadvanced surgical techniques. Part A. 24(3) |
| ISSN: | 1557-9034 |
| Popis: | To analyze the outcomes with mid- to long-term follow-up of laparoscopic ureterolysis (LU) and omental wrapping in retroperitoneal fibrosis (RPF) with obstructive uropathy.Records of 9 patients with RPF who had obstructive uropathy at presentation and had undergone LU and omental wrapping at our center during January 2004 to June 2012 were collected and analyzed.Six females and three males underwent LU for RPF. Underlying causes of RPF could not be found in 8 (89%) cases. Two patients underwent bilateral LU. Mean operative time and estimated blood loss were 213 minutes (range, 180-280 minutes) and 119 mL (range, 70-200 mL), respectively. No case required conversion to open surgery. The only significant intraoperative complication (1/9 [11%]) was ureteral injury, which was easily repaired intraoperatively. The postoperative complication rate was 44% (4/9). Most complications (75% [3/4]) were minor and did not need specific treatment. The mean follow-up period was 46 months (range, 4-72 months). The success rate at last follow-up was 89%.Treatment of RPF is still controversial. Any future prospective randomized comparative trials seem unlikely in view of the low incidence of RPF. LU and omental wrapping in the setting of obstructive uropathy are safe and an effective alternative with a high success rate at mid- to long-term follow-up. |
| Databáze: | OpenAIRE |
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