Transperitoneal laparoscopic pyeloplasty in the treatment of ureteropelvic junction obstruction.

INTRODUCTION: Laparoscopic pyeloplasty was first described by Schuessler. During the last decade, this technique has been developed in order to achieve the same results as open surgery, with lower rates of morbidity and complications. In this study we review our experience using laparoscopic pyeloplasty as the gold standard for the treatment of the ureteropelvic junction obstruction (UPJO).

MATERIAL AND METHODS: We performed a retrospective review of 62 laparoscopic pyeloplasties carried out at our center. In the last 2 years we used 3 mm and 5 mm ports in order to achieve better cosmetics results. Demographic data is described and the functionality of the affected kidney and surgical data, among others were analyzed statistically. In the case of bilateral statistical tests were considered significant as those with p values <0.05.

RESULTS: The most frequent reason for consultation was ureteral pain. Patients mean age was 40 years and 94% of them had preoperative renogram showing a full or partial obstructive pattern. The right side was affected in 61% of cases and the left in the remaining 39%. The presence of stones was observed in 12 patients and crossing vessels in 58% of cases. The average stay was 3.72 days. Post-surgery complications were observed in two patients. The operative time was 178 minutes. Mean follow-up was 45 months and a success was achieved in 91%.

CONCLUSIONS: The transperitoneal laparoscopic pyeloplasty has become the gold standard for the treatment of ureteropelvic junction stenosis in our center because of high success rate, shorter postoperative stay, and low intra and postoperative complications.