Laparoscopic repair of circumcaval ureter: one-year follow-up of three patients and literature review.
OBJECTIVE
To describe our experience and 1-year follow-up of 3 patients with circumcaval ureter (CU) treated laparoscopically, with the introduction of a new stenting method and review of the published data. Because of its rarity, more reports are needed to advocate more comprehensive knowledge about the preferred surgical technique for the treatment of CU.


METHODS
Since November 2005, 3 patients with symptomatic CU have undergone laparoscopic repair of their anomaly at our institutes. In all 3 cases, the ureter was transected and positioned anteriorly with an end-to-end anastomosis. In 2 cases, the retrocavally located ureteral segment was resected.


RESULTS
The mean operative time in our series was 210 minutes, without any intraoperative or early postoperative complications. In 1 patient, a slight ureteral stricture was detected that resolved with reinsertion of a double-J stent. Histopathologic examination of the resected ureteral segments revealed sclerosis and muscular hypertrophy. All patients remained symptom free during the 1 year of follow-up.


CONCLUSIONS
With all the advantages of a minimally invasive procedure and preserving therapeutic efficacy, the laparoscopic approach should be considered a standard choice for surgical treatment of CU in symptomatic patients. Care should be taken to diagnose and excise the pathologically narrowed ureteral segment.
Department of Urology, University of Pécs Medical School, Pécs, Hungary. bafariborz@yahoo.com
Fariborz
F
Bagheri
Csaba
C
Pusztai
Arpád
A
Szántó
Endre
E
Holman
Zsolt
Z
Juhász
Tamás
T
Beöthe
Bányai
B
Dániel
László
L
Farkas
D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008297:Male; D011474:Prosthesis Design; D015607:Stents; D013997:Time Factors; D014513:Ureter / Q000002:abnormalities* / Q000601:surgery*; D014656:Vascular Surgical Procedures; D014682:Vena Cava, Inferior / Q000002:abnormalities* / Q000601:surgery*