title: Intraoperative and postoperative complications of laparoscopic pyeloplasty: a single surgical team experience with 236 cases.
abstract: OBJECTIVE
  To describe and analyze a single surgical team's experience with intraoperative and postoperative complications arising from the Anderson-Hynes transperitoneal laparoscopic pyeloplasty (LP) procedure in the treatment of patients with ureteropelvic junction obstruction (UPJO).
  
  
  METHODS
  There were 236 consecutive patients who underwent transperitoneal LP over a period of 8 years (2004-2012). These patients' records were retrospectively analyzed for intraoperative and postoperative complications. Of the 236 patients, 111 (47.0%) were males and 125 (53%) were females. In 226 patients, surgical indication was primary UPJO, and in 10 patients, recurrent obstruction. Two hundred and eleven patients (89.4%) were symptomatic.
  
  
  RESULTS
  Mean operative time was 96.5 minutes (range 45-360 min). The mean blood loss was 20 mL (range 5-500 mL), and no blood transfusions were necessary. The overall success rate was 97% (229 patients) with a mean follow-up of 38 months (range 6-84 mos). In 86 of the 94 patients who presented with a crossing vessel (91.5%), the anomalous crossing vessel was transposed to the ureteropelvic junction (UPJ) dorsally because of evident obstruction. The mean postoperative hospital stay was 4.2 days (range 3-14 days). All 211 preoperative symptomatic patients reported a complete resolution of symptoms after the procedure. Intraoperative incidents occurred in nine (3.8%) patients, while postoperative complications occurred in 32 (13.5%) patients.
  
  
  CONCLUSIONS
  Our retrospective analysis confirms that LP is an efficacious and safe procedure resulting in a reported success rate of 97% and a concomitant low level of intraoperative (3.8%) and postoperative complications (13.6%). Major complications necessitating active management occur in a low percentage of cases (5.9% of patients). The most frequent and severe intraoperative complications are related to the Double-J stent insertion. The most common postoperative complication is urine leakage.
authors.affiliation: 1 Urology Unit, AORN Cardarelli Hospital , Naples, Italy .
authors.forename: Paolo
authors.initials: P
authors.lastname: Fedelini
authors.forename: Paolo
authors.initials: P
authors.lastname: Verze
authors.forename: Clemente
authors.initials: C
authors.lastname: Meccariello
authors.forename: Davide
authors.initials: D
authors.lastname: Arcaniolo
authors.forename: Domenico
authors.initials: D
authors.lastname: Taglialatela
authors.forename: Vincenzo G
authors.initials: VG
authors.lastname: Mirone
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D007682:Kidney Pelvis / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications; D011184:Postoperative Period; D019651:Plastic Surgery Procedures / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects; D014517:Ureteral Obstruction / Q000601:surgery*; D055815:Young Adult