7 ARE THERE DIFFERENCES IN OUTCOME OF LAPAROSCOPIC AND ROBOT ASSISTED PYELOPLASTIES AND HOW LONG IS STENTING OF THE ANASTOMOSIS NECESSARY?

Abstract

You have accessJournal of UrologyTrauma/Reconstruction: Trauma & Reconstructive Surgery I1 Apr 20127 ARE THERE DIFFERENCES IN OUTCOME OF LAPAROSCOPIC AND ROBOT ASSISTED PYELOPLASTIES AND HOW LONG IS STENTING OF THE ANASTOMOSIS NECESSARY? Hansjoerg Danuser, Patrick Stucki, Giovanni B. di Pierro, and Agostino Mattei Hansjoerg DanuserHansjoerg Danuser Luzern, Switzerland More articles by this author , Patrick StuckiPatrick Stucki Luzern, Switzerland More articles by this author , Giovanni B. di PierroGiovanni B. di Pierro Luzern, Switzerland More articles by this author , and Agostino MatteiAgostino Mattei Luzern, Switzerland More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.049AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The aim of this study to analyse our consecutive series of 86 patients with ureteropelvic junction obstruction (UPJO) treated by laparoscopic (LPP) or robot assisted laparoscopic (RALPP) pyeloplasty and to answer 2 questions: 1. Are there differences in outcome after LPP and RALPP. 2. Are there differences in outcome by stenting of the pyeloplasty for 1 compared to 4 weeks. METHODS 86 patients were planned to undergo LPP (34) or RALPP (52). Preoperative work-up included an IVU or CT-Scan, a diuretic renography (DR) and a retrograde ureteropyelography followed by insertion of a 6 Fr JJ-stent as a preparatory procedure. Technically we performed a dismembered pyeloplasty (Anderson Hynes). A bladder catheter was left for 2 days after surgery. The JJ-stent was removed according to a prospective randomization after 1 or 4 weeks. Follow-up controls included an IVU 3 months, a DR 6 months and an ultrasound 1,3, 5 year postoperatively. RESULTS Preoperative data of the LPP- and the RALPP-series as well as the series stented for 1 and 4 weeks were comparable. In 4 patients (3 LPP and 1 RALPP) the intervention had to be converted to a successful open procedure, due to extensive abdominal scarring (3) or a scarred shortened ureter after unsuccessful endopyelotomy (1). Therefore 31 LPP- and 51 RALPP-patients were analyzed and the results presented in the following table. Results Surgery time (min) Hosp. time (days) Minor complications () Patency UPJ () Split renal function () Residual symptoms () LLP(n=31) 272±64 7.3±2.8 16 100 39±12 10 RALPP(n=51) 207±54 5.1±1.5 6 100 45±10 4 p-value <0.001 <0.001 0.16 1 0.04 0.3 In the randomized trial to stent the anastomosis 1 or 4 weeks, 33 and 31 patients were analysed. There was no significant difference in outcome of the groups stented for 1 or 4 weeks regarding complications, patency of the UPJ, split renal function and residual symptoms. CONCLUSIONS LPP and RALPP are safe and minimally invasive procedures with excellent success rates. Time of intervention and hospitalization seem to be shorter in the RALPP series. Stenting of the UPJ-anastomosis for 1 week is sufficient. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e3 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hansjoerg Danuser Luzern, Switzerland More articles by this author Patrick Stucki Luzern, Switzerland More articles by this author Giovanni B. di Pierro Luzern, Switzerland More articles by this author Agostino Mattei Luzern, Switzerland More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...