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Laparoscopic Transperitoneal pyeloplasty for Ureteropelvic junction Obstruction: Preliminary Results from 26 Cases

Surgical Science 2023年第5期14卷 309-320页

作者： Cyril Kamadjou Divine Enoru Eyongeta Annie Kameni Wadeu Patrick Fotso Gwabap Bertin Njinou Ngninkeu Edouard Hervé Moby Medico Surgical Centre of Urology and Mini Invasive Surgery Douala Cameroon Department of Surgery and Specialties Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Surgery Faculty of Health and Sciences University of Buea Buea Cameroon Clinic of Aeroport Douala Cameroon

Background and Objectives: pyelo-ureteral junction Syndrome (PUJS) is the most common obstructive malformation of the upper urinary tract in children and adults. The standard treatment is open pyeloplasty using the Kuss-Anderson technique. Because of the minimally invasive nature of the laparoscopic approach, it has become the approach of choice for the management of this pathology. We present the results of laparoscopic transperitoneal pyeloplasty used in the management of PUJS. Materials and Methods: This was a retrospective study from 2015 to 2020, including 26 patients who underwent laparoscopic transperitoneal pyeloplasty for PUJS. Results: Twenty-six patients, including 18 (69.2%) men and 6 (30.8%) women, with a mean age of 35.42 ± 13.62 years, were treated. Renal colic was the primary symptom in the majority of the cases (22, 84.6%)). The diagnosis was confirmed in all patients through an abdominal CT scan, which revealed that all 26 patients had hydronephrosis. Half of the patients (50.0%) were classified as Valayer-Cendron Type II, and eight (30.8%) patients had associated stones. Seventeen (65.4%) patients had pathologies on the left side, and all patients were treated using the Kuss-Anderson technique with a median operating time of 108.5 (90.0 - 136.0) minutes. The uncrossing of lower pole vessels was performed in 10 patients. The average duration of hospitalisation was 2.23 ± 0.82 days. No conversion was observed, and after an average follow-up of 53.69 days, the success rate was 92.3%. Conclusion: Laparoscopic pyeloplasty is a minimally invasive technique of choice for the treatment of pyelo-ureteral junction obstruction. It is dependable, repeatable, and produces good functional outcomes that are equal to those of traditional surgery.

关键词： pyelo-ureteral junction Lower Pole Vessel pyeloplasty Double J Stent

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