Changwei Ji1, Gutian Zhang1, Shiwei Zhang1, Xiaozhi Zhao1, Huibo Lian1, Xiaogong Li1, Weidong Gan1, Hongqian Guo2. 1. Department of Urology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China. 2. Department of Urology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China. Email: dr.guohongqian@gmail.com.
Abstract
OBJECTIVE: To analyze the results of transperitoneal and retroperitoneal laparoscopic ureteroureterostomy procedure in the treatment of patients with retrocaval ureter. METHODS: From May 2004 to December 2012, 18 patients including 12 male and 6 female patients were operated for retrocaval ureter, the average age was (37 ± 10) years (range 17-55 years). Eight patients underwent transperitoneal laparoscopic ureteroureterostomy (transperitoneal laparoscopic group), and the other 10 patients' laparoscopic procedure were performed via retroperitoneal approach(retroperitoneal laparoscopic group). These patients' records were retrospectively analyzed for perioperative characteristics, complications and follow-up results. A two-tailed Student's t-test was used to compare perioperative data between the two groups. RESULTS: Technical success was acquired in all 18 laparoscopic procedures. Mean operative time of transperitoneal and retroperitoneal laparoscopic group was (85 ± 20) minutes (60-130 minutes) and (98 ± 30) minutes (70-180 minutes) , respectively. There was no difference in operation time between the two groups (t = 1.03, P > 0.05). The blood loss was less than 50 ml in all the patients. Comparison of anal exhaust time between the two groups showed no statistic difference (t = 0.16, P > 0.05). No perioperative complication was observed. Intravenous pyelography or CT urography 3 months after the operation revealed a widely patent anastomosis with considerable improvement in hydronephrosis in all patients. There was no recurrence at a mean follow up of (40 ± 24) months (range 12-115 months). CONCLUSION: Both transperitoneal and retroperitoneal laparoscopic ureteroureterostomy are effective and minimally invasive surgical alternative for the management of retrocaval ureter.
OBJECTIVE: To analyze the results of transperitoneal and retroperitoneal laparoscopic ureteroureterostomy procedure in the treatment of patients with retrocaval ureter. METHODS: From May 2004 to December 2012, 18 patients including 12 male and 6 female patients were operated for retrocaval ureter, the average age was (37 ± 10) years (range 17-55 years). Eight patients underwent transperitoneal laparoscopic ureteroureterostomy (transperitoneal laparoscopic group), and the other 10 patients' laparoscopic procedure were performed via retroperitoneal approach(retroperitoneal laparoscopic group). These patients' records were retrospectively analyzed for perioperative characteristics, complications and follow-up results. A two-tailed Student's t-test was used to compare perioperative data between the two groups. RESULTS: Technical success was acquired in all 18 laparoscopic procedures. Mean operative time of transperitoneal and retroperitoneal laparoscopic group was (85 ± 20) minutes (60-130 minutes) and (98 ± 30) minutes (70-180 minutes) , respectively. There was no difference in operation time between the two groups (t = 1.03, P > 0.05). The blood loss was less than 50 ml in all the patients. Comparison of anal exhaust time between the two groups showed no statistic difference (t = 0.16, P > 0.05). No perioperative complication was observed. Intravenous pyelography or CT urography 3 months after the operation revealed a widely patent anastomosis with considerable improvement in hydronephrosis in all patients. There was no recurrence at a mean follow up of (40 ± 24) months (range 12-115 months). CONCLUSION: Both transperitoneal and retroperitoneal laparoscopic ureteroureterostomy are effective and minimally invasive surgical alternative for the management of retrocaval ureter.