Retroperitoneal versus transperitoneal laparoscopic pyeloplasty: our experience.
OBJECTIVE
Laparoscopic pyeloplasty, which has been quoted to have a success rate equivalent to open pyeloplasty for ureteropelvic junction obstruction (UPJO), can be performed transperitoneally and retroperitoneally. The aim of the present study is to report our experience with these 2 routes of laparoscopic pyeloplasty and to further improve our understanding of the merits and demerits of these 2 routes.


METHODS
A total of 47 laparoscopic pyeloplasties were performed at our center from June 2000 to August 2009. Twelve pyeloplasties were performed transperitoneally and 35 retroperitoneally.


RESULTS
In the retroperitoneal group, we had a success rate of 91.5% after a mean follow-up of 22 months, and in the transperitoneal group, we had a success rate of 91.7% after a mean follow-up of 48 months. The mean operative time was 156 min in the retroperitoneal group and 195 min in the transperitoneal group.


CONCLUSIONS
This study shows a success rate comparable with open pyeloplasty and favors the retroperitoneal route with a shorter operative time, less dissection needed, a higher sensitivity of detecting crossing vessels, a decreased risk in visceral injury and an early start of oral feeds.
Qadri
Syed Javid Farooq
SJ
Department of Surgery, Government Medical College Srinagar, Srinagar, India. drjavid11 @ gmail.com
Khan
Muneer
M
D000328:Adult; D000714:Anastomosis, Surgical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009398:Nephrology / Q000379:methods; D011183:Postoperative Complications; D012187:Retroperitoneal Space / Q000601:surgery*; D015607:Stents; D013514:Surgical Procedures, Operative / Q000379:methods*; D014517:Ureteral Obstruction / Q000175:diagnosis / Q000601:surgery*; D014572:Urology / Q000379:methods*