Landa-Juárez S, Andraca-Dumit R, García-Hernández C, De la Cruz-Yañez H, Moussali-Flah L, Ramos-Salgado F

Language: Spanish
References: 35
Page: 12-17
PDF size: 142.78 Kb.

ABSTRACT

Objective: To report on the authors’ experience with minimally invasive treatment of ureteropelvic stenosis.
Methods: From January 2005 to March 2009 one hundred thirty pyeloplasties were carried out to correct ureteropelvic stenosis. Eighteen of the procedures were laparoscopic and one of them was retroperitoneal. External drain was left in place in all cases and renal pelvis was remodeled only when there was severe hydronephrosis.
Results: Eighteen laparoscopic pyeloplasties were carried out. Fourteen were transmesenteric corresponding to left kidneys, three were retrocolic, and one was retroperitoneal. Mean patient age was 7.8 years. Mean surgery duration was 255 minutes. Three patients presented with urine leak as complication.
Discussion: Transmesenteric laparoscopic approach enabled rapid and sufficient dissection of ureteropelvic stenosis with minimal mobilization of abdominal organs. There is no need to enter the peritoneum with retroperitoneal approach and it enables rapid identification of the renal hilum and pelvis. The disadvantage is reduced work space due to limited area between trocars and therefore it is the authors’ opinion that it is a technically demanding approach that is better used in right ureteropelvic stenosis and in older children.

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