Laparoscopic pyeloplasty: comparison between retroperitoneoscopic and transperitoneal approach.
OBJECTIVE
To compare both approaches of laparoscopic pyeloplasty, transperitoneal vs retroperitoneoscopy.


METHODS
A total of 65 procedures were performed in 62 patients, 36 females and 26 males. Laparoscopic pyeloplasty with Anderson Hynes technique was performed transperitoneal in 34 cases and retroperitoneal in 31 cases. Parameters studied were the operative duration, the rate of conversion to open approach, transposition of crossing vessel, complications and reintervention, results, and the duration of hospitalization. Then, overall success rate for both approaches was evaluated in the presence or absence of crossing vessels, and if transposition of crossing vessel was performed vs without.


RESULTS
The overall success rate for both procedures was 85% (87% for the retroperitoneal vs 82% for the transperitoneal approach). The mean operative duration was 231.69 ± 59.97 and 194.76 ± 25.37 minutes for the retroperitoneal and transperitoneal approaches, respectively (P = .029). The rate of conversion was 19.35% (6 of 31) and 2.9% (1 of 34) for the retroperitoneal and transperitoneal approaches, respectively (P = .047). No significant statistical difference was noted between both techniques related to the age of patient, the hospital stay, and intraoperative and postoperative complications. Transposition of crossing vessel had no effect on the results (81.25% with transposition and 80% if not, P = .93).


CONCLUSIONS
Retroperitoneoscopic approach is associated with longer operative time and more conversion rate than transperitoneoscopy. However, the overall outcomes of laparoscopic transperitoneal pyeloplasty vs retroperitoneoscopic were comparable.
Service d'Urologie, Andrologie et Transplantation Rénale, CHU Rangueil, Toulouse, France.
Sami
S
Abuanz
Xavier
X
Gamé
Jean-Baptiste
JB
Roche
Julien
J
Guillotreau
Marc
M
Mouzin
Fédérico
F
Sallusto
Wassim
W
Chaabane
Bernard
B
Malavaud
Pascal
P
Rischmann
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006869:Hydronephrosis / Q000601:surgery; D007669:Kidney Calculi / Q000601:surgery; D007682:Kidney Pelvis / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010537:Peritoneum; D011183:Postoperative Complications / Q000209:etiology; D011300:Preoperative Care / Q000379:methods; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000601:surgery; D014552:Urinary Tract Infections / Q000601:surgery; D055815:Young Adult