Extraperitoneal laparoscopic repair of ureteropelvic junction obstruction: initial experience in 15 cases.

摘要

OBJECTIVES: To assess the feasibility and results of retroperitoneal laparoscopic pyeloplasty in the treatment of ureteropelvic junction obstruction. METHODS: From September 1996 to January 1999, 15 patients underwent extraperitoneal laparoscopic pyeloplasty for ureteropelvic junction obstruction. Aberrant vessels were noted in 4 patients. Dismembered pyeloplasty was performed in 7 patients and nondismembered Fenger plasty in 7 patients. Pyeloplasty was not possible in 1 patient. RESULTS: Fourteen of the 15 procedures were successfully completed. The procedure was not possible in 1 patient who had already undergone endopyelotomy repair. The mean operating time was 178 minutes (range 100 to 250), and the mean postoperative hospital stay was 4.8 days (range 1 to 14). Postoperative complications occurred in 3 patients (two hematomas and one urinoma). Radiographic assessment by intravenous urography 3 months after the procedure showed good results. CONCLUSIONS: Retroperitoneoscopy, by providing easy and rapid access to the retroperitoneal space, seems to be a valuable alternative treatment for ureteropelvic junction obstruction.