Retroperitoneoscopic upper pole nephroureterectomy in duplex kidney: focus on the role of dilated upper pole ureter.
OBJECTIVE
To describe our technique and experience with retroperitoneoscopic upper pole nephroureterectomy in duplex kidney, focusing on the role of dilated upper ureter.


METHODS
From November 2004 to August 2011, retroperitoneoscopic upper pole nephroureterectomy was performed in 31 patients with a duplex kidney by a single, experienced laparoscopic surgeon. We developed our own surgical technique to suit this technically challenging procedure. Follow-up studies were performed using renal ultrasonography, intravenous urography (IVU) and/or dimercaptosuccinic acid (DMSA) renal scan in all patients at 3 months postoperatively and annually thereafter.


RESULTS
All procedures were completed laparoscopically without conversion to open surgery and blood transfusion. The mean operative time was 106 (90-157) min. The estimated blood loss was < 50 mL in all cases. The mean postoperative hospital stay was 4.2 (3-7) days. Perioperative complications were limited to 1 case of peritoneal tear during a procedure and 1 case of transient postoperative fever. No major intraoperative and postoperative complication occurred. With the mean follow-up period of 41 months (range 3 to 80), no case was observed to have functional loss of the remaining lower moiety on postoperative IVU or DMSA renal scan.


CONCLUSIONS
Retroperitoneoscopic upper pole nephroureterectomy using our technique is safe and effective.
Department of Urology,Xiangya Hospital, Central South University, Changsha, Human Province, China.
Zhi
Z
Chen
Department of Urology,Xiangya Hospital, Central South University, Changsha, Human Province, China.
Zheng-Yan
ZY
Tang
Department of Urology,Xiangya Hospital, Central South University, Changsha, Human Province, China.
Ben-Yi
BY
Fan
Department of Urology,Xiangya Hospital, Central South University, Changsha, Human Province, China.
Xiang
X
Chen
Department of General Surgery, Xiangya Hospital, Central South University.
Peng
P
Zhou
Department of Urology,Xiangya Hospital, Central South University, Changsha, Human Province, China.
Yan-Cheng
YC
Luo
Department of Urology,Xiangya Hospital, Central South University, Changsha, Human Province, China.
Yao
Y
He
Department of Urology,Xiangya Hospital, Central South University, Changsha, Human Province, China.
Chao-Qun
CQ
Xie
Department of Urology,Xiangya Hospital, Central South University, Changsha, Human Province, China.
Chen
C
Lai
Department of Urology,Xiangya Hospital, Central South University, Changsha, Human Province, China.
Xiao-Long
XL
Fang
D000293:Adolescent; D000328:Adult; D016063:Blood Loss, Surgical; D002614:Chelating Agents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007668:Kidney / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012187:Retroperitoneal Space / Q000601:surgery; D004113:Succimer; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014513:Ureter / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult
D002614:Chelating Agents; D004113:Succimer