PURPOSE: Traditionally transperitoneal laparoscopic access to ureteropelvic junction obstruction has been performed in retrocolic fashion. We assessed transmesenteric laparoscopic pyeloplasty to correct ureteropelvic junction obstruction and compared results to those in patients undergoing traditional retrocolic laparoscopic pyeloplasty. MATERIALS AND METHODS: Between August 1999 and July 2005, 188 consecutive transperitoneal laparoscopic pyeloplasties were performed at our institution. A total of 18 patients underwent a transmesenteric approach and 170 underwent the classic retrocolic approach. Patient selection for the transmesenteric approach was at surgeon discretion with the inclusion criterion of recognition of the renal pelvis and/or ureter through the descending colonic mesentery. RESULTS: Compared to patients undergoing traditional retrocolic procedure the transmesenteric approach was more commonly applied in younger individuals and males, and for pathological conditions on the left side and malrotated kidneys. The transmesenteric approach lowered operative time by a mean of 22.5% and decreased hospital stay by 19.2%. The patency success rate was 100% at a mean followup of 18.6 months for the transmesenteric approach and 94.1% at a mean followup of 22 months for the retrocolic approach. CONCLUSIONS: In a select group of patients transmesenteric pyeloplasty may represent a more rapid alternative to the transperitoneal retrocolic approach and speed convalescence with similar success rates.
PURPOSE: Traditionally transperitoneal laparoscopic access to ureteropelvic junction obstruction has been performed in retrocolic fashion. We assessed transmesenteric laparoscopic pyeloplasty to correct ureteropelvic junction obstruction and compared results to those in patients undergoing traditional retrocolic laparoscopic pyeloplasty. MATERIALS AND METHODS: Between August 1999 and July 2005, 188 consecutive transperitoneal laparoscopic pyeloplasties were performed at our institution. A total of 18 patients underwent a transmesenteric approach and 170 underwent the classic retrocolic approach. Patient selection for the transmesenteric approach was at surgeon discretion with the inclusion criterion of recognition of the renal pelvis and/or ureter through the descending colonic mesentery. RESULTS: Compared to patients undergoing traditional retrocolic procedure the transmesenteric approach was more commonly applied in younger individuals and males, and for pathological conditions on the left side and malrotated kidneys. The transmesenteric approach lowered operative time by a mean of 22.5% and decreased hospital stay by 19.2%. The patency success rate was 100% at a mean followup of 18.6 months for the transmesenteric approach and 94.1% at a mean followup of 22 months for the retrocolic approach. CONCLUSIONS: In a select group of patients transmesenteric pyeloplasty may represent a more rapid alternative to the transperitoneal retrocolic approach and speed convalescence with similar success rates.
Authors: Stephanie J Symons; Victor Palit; Chandra Shekhar Biyani; Jon J Cartledge; Anthony J Browning; Adrian D Joyce Journal: Indian J Urol Date: 2009-01
Authors: Hyun Ho Han; Won Sik Ham; Jang Hwan Kim; Chang Hee Hong; Young Deuk Choi; Sang Won Han; Byung Ha Chung Journal: Yonsei Med J Date: 2013-01-01 Impact factor: 2.759
Authors: Tomasz Szydelko; Wojciech Apoznański; Dariusz Janczak; Wojciech Panek Journal: Wideochir Inne Tech Maloinwazyjne Date: 2015-09-14 Impact factor: 1.195