Retroperitoneal laparoscopic management of ureteropelvic junction obstruction in patients with horseshoe kidney - Abstract

OBJECTIVE: To report our experience with retroperitoneal laparoscopic pyeloplasty for the management of ureteropelvic junction (UPJ) obstruction in patients with horseshoe kidneys (HSKs).

MATERIALS AND METHODS: Between March 2005 and May 2012, 2 boys, 5 men, and 1 woman (mean age, 23.9 years; range, 7-42 years) with HSKs underwent retroperitoneal laparoscopic dismembered pyeloplasties for UPJ obstructions with transections of the isthmuses. One patient had a renal calculus that was extracted during surgery. The follow-up included clinical evaluations, ultrasonography, intravenous urography, and diuretic renography.

RESULTS: Retroperitoneal laparoscopic dismembered pyeloplasty was feasible in all cases. The median operative time was 192 minutes (range, 148-252 minutes), and there were no perioperative complications. The mean hospital stay was 5.8 days (range, 4-7 days). The mean follow-up time was 45 months (range, 18-96 months). All patients were asymptomatic and exhibited decreased pelvic dilation at follow-up.

CONCLUSION: The retroperitoneal laparoscopic approach is feasible and safe for pyeloplasty in UPJ obstruction associated with HSK. Isthmectomy and a fully mobilized kidney offer better surgical exposure during the operation.

Written by:
Wang P, Xia D, Ma Q, Wang S.   Are you the author?
Department of Urology, The First Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, Zhejiang Province, China; Department of Urology, Ningbo First Hospital, the Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, China.

Reference: Urology. 2014 Sep 19. pii: S0090-4295(14)00754-7.
doi: 10.1016/j.urology.2014.07.029


PubMed Abstract
PMID: 25242437

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