Feasibility and Safety of Retroperitoneal Laparoendoscopic Single-Site Dismembered Pyeloplasty: A Clinical Report of 10 Cases
| Autor: | Yan-Cheng Luo, Zhong-Hua Wu, Chao-Qun Xie, Zhi Chen, Xiang Chen, Yao He, Chen Lai, Nan-Nan Li |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Pyeloplasty medicine.medical_specialty Adolescent medicine.medical_treatment Axillary lines Ureteropelvic junction Young Adult Clinical report Single site medicine Humans Kidney Pelvis Retroperitoneal Space Child Retroperitoneal approach Retrospective Studies Skin incision business.industry Laparoscopes Surgery medicine.anatomical_structure Renal ultrasonography Feasibility Studies Urologic Surgical Procedures Female Laparoscopy business Ureteral Obstruction |
| Zdroj: | Journal of Laparoendoscopic & Advanced Surgical Techniques. 22:685-690 |
| ISSN: | 1557-9034 1092-6429 |
| DOI: | 10.1089/lap.2012.0164 |
| Popis: | To retrospectively review our experience with respect to evaluating the feasibility and safety of laparoendoscopic single-site (LESS) dismembered pyeloplasty for ureteropelvic junction obstruction (UPJO) through a retroperitoneal approach.Between March 2011 and January 2012, 10 consecutive patients underwent LESS retroperitoneoscopic dismembered pyeloplasty performed by one experienced laparoscopic surgeon at our institution. A single-port access was inserted through a 2.5-cm transverse skin incision below the 12th rib along the midaxillary line. Standard steps of the multisite retroperitoneoscopic Anderson-Hynes dismembered pyeloplasty technique using conventional instruments or a combination of conventional and bent laparoscopic instruments were performed. Follow-up studies were conducted by intravenous urography (IVU), diuretic renal scan, and renal ultrasonography.LESS retroperitoneoscopic dismembered pyeloplasty was successful in 9 patients, whereas 1 required four-port retroperitoneoscopic conversion because of difficulties in remaining in the retroperitoneal space due to a peritoneal tear during the procedure. The mean operative time was 148.4 minutes (range, 103-210 minutes). The mean estimated blood loss was 31 mL (range, 10-70 mL), and the mean postoperative hospital stay was 5.7 days (range, 3-13 days). Intraoperative complications were limited to the one case of peritoneal tear. An aberrant crossing vessel was noted in 4 patients, and transposition was not required in these patients. Urine leakage occurred in 1 patient postoperatively and was successfully treated by conservative management. The mean follow-up period was 6.2 months (range, 5-10 months). Satisfactory drainage with decreased hydronephrosis on IVU, diuretic renal scan, and renal ultrasonography was observed in all cases at the 3-month imaging studies.In experienced hands, LESS retroperitoneoscopic dismembered pyeloplasty is a feasible and safe alternative for correcting UPJO, although it remains technically challenging. The long-term outcome awaits further studies. |
| Databáze: | OpenAIRE |
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