Landa-Juárez S, Ruiz-Castro NM, Miguel-Gómez RD, Hernández-Aguilar G, Andraca-Dumit R

Language: Spanish
References: 28
Page: 120-126
PDF size: 117.88 Kb.

ABSTRACT

Introduction: The gold standard for treating ureteropelvic stenosis (EUP) is Anderson Hynes pyeloplasty (AH), with good results in> 90% of cases. The evolution of the approach has shifted from open surgery to minimally invasive with their variants and retroperineoscopía celioscopía. The aim of this paper is to report our experience in the treatment of EUP for minimally invasive.
Material and Methods: From January 2005 to March 2009, 130 pyeloplasties made to correct the EUP in our institution. Surgical technique. The approaches were Transmesenterico and retoperitoneal with the patient in lateral decubitus
Results: We performed 18 laparoscopic pyeloplasty. Fourteen of these were accounted transmesentéricas and left kidneys. The operative time ranged from 180 to 330 minutes with an average of 255 minutes. The complications observed were: stenosis of the anastomosis in a patient which does not let you double-catheter “J” and urinary fistula in another patient that required re-operation for offline.
Discussion: The laparoscopic approach transmesentérico (ALT) allowed a sufficient and rapid dissection of the EUP with minimal mobilization of the abdominal organs. The advantage of ALT is that detachment and mobilization avoided with the technique required colonic celioscópica retrocolic and its disadvantage is that its application was limited to treatment of EUP left given the anatomical location of the left kidney on the right.
Retroperineoscópico approach offered the advantage of avoiding entering the peritoneal and allowed the rapid identification of the hilum and renal pelvis but the workspace is very limited by the proximity of the trocar that make this a technically demanding approach we believe to be most EUP rights and utility in older children. The results regarding the solution of the UP obstruction were similar to those of open pyeloplasty, although it is necessary to increase the number of cases especially in the section of the retroperineoscopía.

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