Laparoscopic upper-pole nephroureterectomy for duplex kidney anomalies

Abstract

Objectives Eight patients with urinary tract duplex anomalies underwent laparoscopic heminephrectomy using retroperitoneal or transperitoneal approach were retrospectively analyzed.Methods The sites of surgery of all cases were upper heminephrectomy,including 5 in the left and 3 in the right.All cases were dignosised with radiography.Four patients treated with retroperitoneal approach,while another 4 treated with transperitoneal approach.Follow - up studies were performed using renal ultrasonography and IVU in all patients.Results All patients underwent laparoscopic surgery successfully without conversion to open surgery or intraoperative complications.The mean operative time was 142 minutes (range 110 ～ 170min).The mean estimated blood loss was 20 mL (range 10 ～ 100),and the mean hospital stay was 7.5 days (range 7 ～ 8).During the follow - up of 3 ～24 months,a urinary infection in the residual ureter stump occurred and was resolved with open surgery.No postoperative complications occurred in other 7 patients as confirmed by radiologic assessment.Conclusions Laparoscopic upper pole nephroureterectomy is a safe and effective procedure and an excellent minimally invasive treatment option for the adult patient with a duplex kidney.The distal upper pole ureter should be transected as far as possible to prevent the recurrence of urinary infection in the residual ureter stump. Key words: Kidney; Ureter; Surgical Procedures,Laparoscopic