Search Asian J Urol Advanced Search
Share 
Asian Journal of Urology, 2018, 5(3): 172-181    doi: 10.1016/j.ajur.2018.03.001
Original Article Current Issue | Archive | Adv Search |
Retroperitoneal laparoscopic non-dismembered pyeloplasty for uretero-pelvic junction obstruction due to crossing vessels: A matched-paired analysis and review of literature
Jens Rassweilera*(),Jan Kleinb,Ali Serdar Goezena
a Department of Urology and Pediatric Urology, SLK Kliniken Heilbronn, University of Heidelberg, Heibronn, Germany
b Department of Urology, Medical School Ulm, University of Ulm, Ulm, Germany
Download: HTML   PDF (4370KB) 
Export: BibTeX | EndNote (RIS)      
Abstract  

Objective: To compare laparoscopic Anderson-Hynes pyeloplasty (LAHP) and retroperitoneal laparoscopic YV-pyeloplasty (LRYVP) in ureteropelvic junction obstruction (UPJ) in presence of a crossing vessels (CV). Methods: Our database showed 380 UPJO-cases,who underwent laparoscopic retroperitoneal surgery during the last 2 decades including 206 non-dismembered LRYVP, 157 dismembered pyeloplasties LAHP, and 17 cases of laparoscopic ureterolysis. Among them 198 cases were suitable for a matched-pair (2:1) analysis comparing laparoscopic retroperitoneal non-dismembered LRYVP (Group 1, n = 131) and dismembered LAHP (Group 2, n = 67) in presence of a crossing vessel. Patients were matched according to age, gender, kidney functions, and obstruction grade. Complications were graded according to modified Clavien-classification. Results: Comparative data were similar between both groups (LRYVP vs. LAHP) including mean operating time (112 min vs. 114 min), complication rates (4.2% vs. 7.3%) mainly Grade 1-2 according to Clavien classification, and success rates (90% vs. 89%). These results reflected in the reviewed literature indicate that LRYVP provides the advantage of minimal dissection in case of CV with similar outcome. However, redundant pelvis and anteriorly crossing vessels still require a dismembered pyeloplasty LAHP. Conclusion: LRYVP has achieved similar results compared with the previous golden standard of open surgery, especially in case of crossing vessels apart from presence of a redundant pelvis or anteriorly crossing vessel. This can be further improved when using the small access retroperitoneoscopic technique respectively mini-laparoscopy.

Key wordsKidney pelvis      Laparoscopy      Ureteropelvic junction obstruction      Mini-laparoscopy      Crossing vessel     
Received: 09 March 2017      Published: 23 July 2018
Corresponding Authors: Rassweiler Jens     E-mail: jens.rassweiler@slk-kliniken.de
Service
E-mail this article
Add to citation manager
E-mail Alert
Articles by authors
Rassweiler Jens
Klein Jan
Serdar Goezen Ali
TRENDMD:   
Cite this article:   
Rassweiler Jens,Klein Jan,Serdar Goezen Ali. Retroperitoneal laparoscopic non-dismembered pyeloplasty for uretero-pelvic junction obstruction due to crossing vessels: A matched-paired analysis and review of literature[J]. Asian Journal of Urology, 2018, 5(3): 172-181.
URL:  
http://www.ajurology.com/EN/10.1016/j.ajur.2018.03.001     OR     http://www.ajurology.com/EN/Y2018/V5/I3/172