title: Long-term outcome of laparoscopic pyeloplasty: multicentric comparative study of techniques and accesses.
abstract: OBJECTIVE
  The aim of the present study was to analyze long-term follow up (18-108 months) of different techniques and routes for laparoscopic repair of uretero-pelvic junction obstruction comparing efficacy and results.
  
  
  METHODS
  A retrospective analyses of 133 laparoscopic pyeloplasties in 132 patients (mean age 35 years) between August 1995 and November 2008 was performed. Transperitoneal route was performed in 114 patients, and retroperitoneal route was performed in 19 patients. Different repair techniques (dismembered and non-dismembered) were applied at the surgeon's discretion.
  
  
  RESULTS
  Average operative time was 127 minutes (range 45-370). Average blood loss was 127 mL, and mean hospital stay was 24 hours. Complications occurred in 9.6% of surgeries, and conversion rate was 1.7%. Urinary leak occurred after eight (6.1%) surgeries, all managed conservatively. Overall success rate of laparoscopic repair was 96%, higher for dismembered versus non-dismembered procedures (97% versus 89%, P = .04).
  
  
  CONCLUSIONS
  Laparoscopic pyeloplasty is a reproducible, highly effective, and minimally invasive treatment for uretero-pelvic junction obstruction. Surgical technique affects operative time and long-term success rates. Dismembered techniques seem to remain more effective after a long-term follow up. Surgical route does not seem to affect success rates.
authors.affiliation: Division of Urology, ABC Medical School, Santo André, Sao Paulo, Brazil.
authors.forename: Roberto Vaz
authors.initials: RV
authors.lastname: Juliano
authors.forename: Rafaela R
authors.initials: RR
authors.lastname: Mendonça
authors.forename: Fernando
authors.initials: F
authors.lastname: Meyer
authors.forename: Maurício
authors.initials: M
authors.lastname: Rubinstein
authors.forename: Marco Túlio Coelho
authors.initials: MT
authors.lastname: Lasmar
authors.forename: Fernando
authors.initials: F
authors.lastname: Korkes
authors.forename: Alessandro
authors.initials: A
authors.lastname: Tavares
authors.forename: Antonio Carlos Lima
authors.initials: AC
authors.lastname: Pompeo
authors.forename: Marcos
authors.initials: M
authors.lastname: Tobias-Machado
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007682:Kidney Pelvis / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000601:surgery*; D055815:Young Adult