Laparoscopic pyeloplasty: the updated McMaster University experience.
OBJECTIVE
The open Anderson-Hynes procedure has an overall success rate of 90% for ureteropelvic junction obstruction. Laparoscopic pyeloplasty (LP) was developed to reduce morbidity and hospital stay while preserving the excellent results. We report on the results of our experience with laparoscopic pyeloplasty.


METHODS
Between January 2001 and May 2006, 77 consecutive patients underwent LP performed by one of 4 surgeons at our institution. Patients were reassessed with ultrasound (U/S) or intravenous pyelogram (IVP) at 6 weeks. Diuretic renal scan and U/S or IVP were performed at 6 months, and subsequent follow-up included a U/S or IVP as well as clinical assessment. Patients were assessed for pain and hydronephrosis on radiologic imaging, clearance on diuretic renal scan (T(1/2)) and differential renal function.


RESULTS
We evaluated 73 patients. The mean patient age was 38 years (range 16-71 yr), the mean operating time was 218 minutes (range 110-409 min), and the mean blood loss was 57 mL (range 25-250 mL). Mean hospital stay was 3.0 days (range 2-7 d). The success rate was 90.4%, and failures were mainly due to poor function after surgery (3 patients). Pyelolithotomy was performed concomitantly on 6 patients, which on average extended operative time by 36 minutes.


CONCLUSIONS
Our success rates are consistent with the LP experience of other centres and are comparable with rates for the open technique. Patients had short hospital stays, and complications were negligible. With experienced surgeons, LP should be the first-line treatment for ureteropelvic junction obstruction.
Dong
Jihao
J
Medical Student.
Wong
Jaime
J
Al-Enezi
Ahmad
A
Kapoor
Anil
A
Whelan
J Paul
JP
Piercey
Kevin
K
Matsumoto
Edward D
ED
Urology. 2004 Jul;64(1):16-21; discussion 21
15245924
Hell J Nucl Med. 2005 Sep-Dec;8(3):154-7
16390020
BJU Int. 2001 Mar;87(4):287-9
11251517
J Urol. 2000 Sep;164(3 Pt 2):1106-10
10958753
J Urol. 2005 Jun;173(6):2081-4
15879847
Eur Urol. 2005 Dec;48(6):973-7
16171940
J Endourol. 2005 Mar;19(2):210-7
15798420
J Endourol. 2005 Mar;19(2):143-6
15798407
J Urol. 1993 Dec;150(6):1795-9
8230507
Urol Clin North Am. 2004 Nov;31(4):737-41
15474600
Can J Urol. 2004 Jun;11(3):2299-302
15287998
J Urol. 1995 Mar;153(3 Pt 1):701-3
7861513
Urology. 2005 Mar;65(3):422-32
15780349
J Endourol. 2006 Oct;20(10):823-6
17094762
Urology. 2006 May;67(5):932-6
16635516
J Urol. 1998 Sep;160(3 Pt 1):685-9
9720521
BJU Int. 2005 Mar;95 Suppl 2:102-5
15720343
Ann Surg. 2006 Apr;243(4):486-91
16552199
Ann Nucl Med. 2003 Dec;17(8):663-8
14971608
J Endourol. 2002 Sep;16(7):431-43
12396434
J Endourol. 2006 Oct;20(10):707-12
17094743
J Urol. 1994 Apr;151(4):934-7
8126829