Laparoscopic pyeloplasty versus antegrade endopyelotomy: comparison in 100 patients and a new algorithm for the minimally invasive treatment of ureteropelvic junction obstruction.

摘要: The aim of this article is to assess the treatment efficacy percutaneous endopyelotomy and laparoscopic pyeloplasty establish a new algorithm in minimally invasive ureteropelvic junction obstruction (UPJO). Hospital records, office charts, radiographic studies patients with UPJO treated either endoscopically (n = 50), laparoscopically or by endopyeloplasty 5) were reviewed. All endopyelotomies performed cold hook-knife technique, all pyeloplasties transperitoneally using an Anderson-Hynes dismembered anastomosis. Successful outcomes defined as relief quantified diuretic renal scans and/or obstructive symptoms. followed for average 16.0 months (range, 2 42 months). In group, age was 44.6 ± 15.6 years, estimated blood loss (EBL) 152.1 112.8 mL, hospital stay 2.5 1.0 days. There no significant change from preoperative postoperative creatinine (1.2 0.7 mg/dL 1.2 [106 62 μmol/L 106 μmol/L]). Success rates included 92% (35 38) primary antegrade 58% (7 12) secondary endopyelotomy. failures 3) had grade 3 4 hydronephrosis. group 37.9 14.8 EBL 108.3 109.4 2.6 0.9 (1.1 0.4 [97 35 97 100% (29 29) repair 95.2% (20 21) repair. statistical difference patient parameters objective when comparing pyeloplasty. skilled hands, highly successful can be expected used treat UPJO. instance associated high degree hydronephrosis, may better served To maximize efficacious outcome, decisions should based on surgeon preference, directed presented algorithm.