Retroperitoneal Laparoscopic Dismembered Anderson-Hynes Pyeloplasty in Treatment of Ureteropelvic Junction Obstruction (Report of 150 cases)

Abstract

To assess the feasibility and efficacy of retroperitoneal laparoscopic dismembered Anderson-Hynes pyeloplasty in the treatment of ureteropelvic junction obstruction (UPJO). Between August 2003 and June 2007, retroperitoneal laparoscopic dismembered Anderson-Hynes pyeloplasty was performed in 150 patients diagnosed with UPJO. All patients were assessed preoperatively by imaging examinations (ultrasonography, computerized tomography, and intravenous or retrograde urography) and isotope diuretic renography. Additionally, of the 150 cases, 16 patients with renal calculi underwent concomitant pyelolithotomy. All surgeries were successful. No conversion to open surgery was observed. The average operating time, blood loss, and postoperative hospital stay was 105 minutes (range 95-190), 35 mL (range 20-80), and 7.4 days (range 6-12), respectively. A crossing vessel was encountered in 70 (46.7%) patients. Concomitant renal calculi were successfully removed in 11 patients. Two cases presented with urinary leakage that disappeared on the 11th and 12th postoperative day, respectively. Success rate was 98% at a mean follow-up of 16 months (range 12-24). Retroperitoneal laparoscopic pyeloplasty provides a minimal invasive treatment modality with low morbidity, short hospital stay, and quick postoperative recovery for patients with UPJO. In experienced hands, laparoscopic pyeloplasty is an effective alternative treatment for UPJO.