title: Laparoscopic pyeloplasty in secondary obstruction.
abstract: OBJECTIVE
  To evaluate the management of secondary ureteropelvic junction (UPJ) obstruction by laparoscopic pyeloplasty.
  
  
  METHODS
  Thirteen patients with symptomatic secondary UPJ obstruction undergoing laparoscopic pyeloplasty were included. Eight patients had obstruction on the right side and five patients on the left. The causes of obstruction were: failed Acucise retrograde endopyelotomy in seven patients, open pyelolithotomy in three, open pyeloplasty in one, retrograde endopyelotomy with laser in one, and laparoscopic pyeloplasty in one. Laparoscopic transperitoneal pyeloplasty was performed in all patients. A Double J stent was introduced antegrade and intraoperatively and removed 6 weeks later in all patients.
  
  
  RESULTS
  Laparoscopic transperitoneal pyeloplasty was successful in 12 patients (92.3%). Operative time ranged from 135 to 270 minutes, with a mean of 195 minutes. The mean hospital stay was 2.2 days (range 2 to 5 days). Follow-up ranged from 16 to 36 months with a mean of 22.4 months. Blood loss was insignificant in all surgeries, and no conversion or intraoperative complications occurred.
  
  
  CONCLUSIONS
  Laparoscopic pyeloplasty for secondary UPJ obstruction in our series was performed without conversion to open surgery. The initial results were similar to those of primary laparoscopy in our series or those of open pyeloplasty reported in the literature. These results led us to consider the laparoscopic correction as a good alternative in such cases.
authors.affiliation: Division of Urology, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Artur Henrique
authors.initials: AH
authors.lastname: Brito
authors.forename: Anuar Ibrahim
authors.initials: AI
authors.lastname: Mitre
authors.forename: Miguel
authors.initials: M
authors.lastname: Srougi
mesh_terms: D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D020878:Device Removal; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007682:Kidney Pelvis / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D011183:Postoperative Complications / Q000601:surgery; D019919:Prosthesis Implantation / Q000295:instrumentation; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery*; D014517:Ureteral Obstruction / Q000209:etiology / Q000601:surgery*