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Laparoscopic Ureterocalicostomy: A Reliable Last Resource

Laparoscopic Ureterocalicostomy: A Reliable Last Resource Background: The operative technique of laparoscopic ureterocalicostomy for significant ureteropelvic junction fibrosis associated with previous stone disease treatment is reported. Patients and Methods: Three female patients (mean age 32 years, range 25–38 years) presented with complications of urolithiasis treatment between 2003 and 2005. Significant pyeloureteral fibrosis was verified in all patients. A laparoscopic ureterocalicostomy to manage such defects was performed. Follow-up included clinical evaluation, nuclear renography, intravenous urography and serum chemistry. Results: The procedure was transperitoneally performed with a 4-port technique. Vascular control of the renal hilum was indicated in 2 cases (cases 1 and 3) with a mean warm ischemia time of 29 min (range 25–32 min). Mean operative time was 150 min (range 90–210 min) and mean blood loss was 550 ml (range 100–1,000 ml). Operations were performed in the left renal unit in all cases. Post-operative pyelograms verified adequate renal unit excretion. No significant variations on pre- and post-operative serum chemistry were verified. At a mean follow-up period of 26 months (range 12–32 months), there was no evidence of renal function loss which was demonstrated by nuclear renography. Conclusion: In experienced hands a difficult procedure such as ureterocalicostomy can be performed by laparoscopy. This is a complex procedure that is indicated in selected cases where the stenosis of the pyeloureteral junction is associated with an intra-renal pelvis. In our experience results are comparable with those previously reported in open surgery. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Current Urology Karger

Laparoscopic Ureterocalicostomy: A Reliable Last Resource

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Publisher
Karger
Copyright
© 2008 S. Karger AG, Basel
ISSN
1661-7649
eISSN
1661-7657
DOI
10.1159/000115408
Publisher site
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Abstract

Background: The operative technique of laparoscopic ureterocalicostomy for significant ureteropelvic junction fibrosis associated with previous stone disease treatment is reported. Patients and Methods: Three female patients (mean age 32 years, range 25–38 years) presented with complications of urolithiasis treatment between 2003 and 2005. Significant pyeloureteral fibrosis was verified in all patients. A laparoscopic ureterocalicostomy to manage such defects was performed. Follow-up included clinical evaluation, nuclear renography, intravenous urography and serum chemistry. Results: The procedure was transperitoneally performed with a 4-port technique. Vascular control of the renal hilum was indicated in 2 cases (cases 1 and 3) with a mean warm ischemia time of 29 min (range 25–32 min). Mean operative time was 150 min (range 90–210 min) and mean blood loss was 550 ml (range 100–1,000 ml). Operations were performed in the left renal unit in all cases. Post-operative pyelograms verified adequate renal unit excretion. No significant variations on pre- and post-operative serum chemistry were verified. At a mean follow-up period of 26 months (range 12–32 months), there was no evidence of renal function loss which was demonstrated by nuclear renography. Conclusion: In experienced hands a difficult procedure such as ureterocalicostomy can be performed by laparoscopy. This is a complex procedure that is indicated in selected cases where the stenosis of the pyeloureteral junction is associated with an intra-renal pelvis. In our experience results are comparable with those previously reported in open surgery.

Journal

Current Urology – Karger

Published: Jan 1, 2008

Keywords: Ureteropelvic junction obstruction; Laparoscopy; Ureterocalicostomy

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