616 UNIVERSITY OF MICHIGAN SURGICAL EXPERIENCE WITH URETEROLYSIS FOR RETROPERITONEAL FIBROSIS: A COMPARISON OF LAPAROSCOPIC AND OPEN SURGICAL APPROACHES

Abstract

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Kidney & Bladder1 Apr 2010616 UNIVERSITY OF MICHIGAN SURGICAL EXPERIENCE WITH URETEROLYSIS FOR RETROPERITONEAL FIBROSIS: A COMPARISON OF LAPAROSCOPIC AND OPEN SURGICAL APPROACHES Nicholas R. Styn, Sara Fraumann, Gary J. Faerber, and J. Stuart Wolf Nicholas R. StynNicholas R. Styn More articles by this author , Sara FraumannSara Fraumann More articles by this author , Gary J. FaerberGary J. Faerber More articles by this author , and J. Stuart WolfJ. Stuart Wolf More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.930AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Retroperitoneal fibrosis (RPF) is a rare process that can lead to extrinsic compression of ureters and subsequent renal failure. Active treatment options include medical management or surgical ureterolysis. Open surgical ureterolysis allows release of the ureters from the fibrotic environment. Laparoscopic ureterolysis has been reported to provide similar benefits with decreased intensity and duration of convalescence. We compared our experience with open surgical and laparoscopic ureterolysis to determine any difference in success and convalescence. METHODS We retrospectively reviewed 22 patients who underwent 25 ureterolysis procedures for RPF between 1997 and 2006 at our institution. Of the patients, 12 had open ureterolysis (OU), and 10 patients underwent laparoscopic ureterolysis (LU). Patients were followed for a median of 24 months. Operative and post-operative parameters, complications, and success rates were compared. RESULTS Laparoscopic ureterolysis was performed in 13 cases (10 patients) on a total of 16 ureters. No conversion to open surgery was required. OU was performed in 12 cases (12 patients) on a total of 16 ureters. LU was associated with a significantly shorter hospital stay than OU (mean 2.1 versus 5.9 days. p=0.004). Laparoscopic intraperitonealization of ureters was performed in 98% of all affected ureters compared to 50% in the OU group (p=0.02). There was no difference between the groups in ability to perform omental wrap, postoperative creatinine level, complication rate, operating time, or transfusion requirement. With a mean follow-up of 30 months in the OU group and 24 months in the LU group, the success rate is 88% after OU and 94% after LU. (p=1.0) CONCLUSIONS Laparoscopic ureterolysis is a safe and effective surgical management of RPF. Laparoscopic ureterolysis offers similar results and a shorter hospital stay compared to open surgical ureterolysis, and should be considered the technique of choice in most cases. Ann Arbor, MI© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e242 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nicholas R. Styn More articles by this author Sara Fraumann More articles by this author Gary J. Faerber More articles by this author J. Stuart Wolf More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...