title: Renal function after laparoendoscopic single site pyeloplasty.
abstract: OBJECTIVE
  Outcomes after laparoendoscopic single site pyeloplasty are limited to small cohort studies with short-term followup. We evaluated the clinical and renal function outcomes of what to our knowledge is the largest laparoendoscopic single site pyeloplasty cohort to date with a mean followup of 12 months.
  
  
  METHODS
  Consecutive patients diagnosed with symptomatic ureteropelvic junction obstruction who underwent robotic or conventional laparoendoscopic single site pyeloplasty were entered into the study. Patient demographics, and preoperative and postoperative renal function outcomes were recorded. Diuretic renogram was performed after stent removal, at 6 months and yearly thereafter.
  
  
  RESULTS
  The cohort included 31 conventional and 22 robotic laparoendoscopic single site pyeloplasties. Four laparoendoscopic single site surgeries (7.8%) were converted to another procedure due to failure to progress. Mean ± SD followup was 12.1 ± 10.7 months and 22 patients had at least 12 months of followup. No intraoperative complications occurred. Complications developed postoperatively in 11 patients (21%), of which 9 were Clavien grade 3 or greater. Preoperative symptoms resolved in 49 of 51 cases (96%). Severe obstruction (half-time greater than 20 minutes) was seen in 32 of 44 patients (73%) at presentation and obstruction resolved (half-time 20 minutes or less) in 41 (93%). Mean preoperative and postoperative half-time was 24.6 ± 13.4 and 8.3 ± 4.1 minutes, respectively, for an improvement of 16.3 ± 12.3 minutes (p <0.01).
  
  
  CONCLUSIONS
  Laparoendoscopic single site pyeloplasty is safe and efficacious. The laparoscopic and robotic techniques provide excellent outcomes in terms of symptomatic relief and radiographic resolution of obstruction.
authors: Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas 75390-9110, USA.
authors: Brian R
authors: BR
authors: Harrow
authors: Aditya
authors: A
authors: Bagrodia
authors: Ephrem O
authors: EO
authors: Olweny
authors: Stephen
authors: S
authors: Faddegon
authors: Jeffrey A
authors: JA
authors: Cadeddu
authors: Jeffrey C
authors: JC
authors: Gahan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D004322:Drainage; D005260:Female; D006801:Humans; D007677:Kidney Function Tests; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012371:Robotics; D018709:Statistics, Nonparametric; D015607:Stents; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000601:surgery*
keywords: C-LESS; CLP; DRG; LESS; R-LESS; T½; UPJO; conventional LESS; conventional laparoscopic pyeloplasty; diuretic renogram; eGFR; estimated glomerular filtration rate; half-time; kidney; laparoendoscopic single site; laparoscopy; robotic LESS; robotics; treatment outcome; ureteral obstruction; ureteral pelvic junction obstruction