title: Retroperitoneal laparoscopic management of ureteropelvic junction obstruction in patients with horseshoe kidney.
abstract: OBJECTIVE
  To report our experience with retroperitoneal laparoscopic pyeloplasty for the management of ureteropelvic junction (UPJ) obstruction in patients with horseshoe kidneys (HSKs).
  
  
  METHODS
  Between March 2005 and May 2012, 2 boys, 5 men, and 1 woman (mean age, 23.9 years; range, 7-42 years) with HSKs underwent retroperitoneal laparoscopic dismembered pyeloplasties for UPJ obstructions with transections of the isthmuses. One patient had a renal calculus that was extracted during surgery. The follow-up included clinical evaluations, ultrasonography, intravenous urography, and diuretic renography.
  
  
  RESULTS
  Retroperitoneal laparoscopic dismembered pyeloplasty was feasible in all cases. The median operative time was 192 minutes (range, 148-252 minutes), and there were no perioperative complications. The mean hospital stay was 5.8 days (range, 4-7 days). The mean follow-up time was 45 months (range, 18-96 months). All patients were asymptomatic and exhibited decreased pelvic dilation at follow-up.
  
  
  CONCLUSIONS
  The retroperitoneal laparoscopic approach is feasible and safe for pyeloplasty in UPJ obstruction associated with HSK. Isthmectomy and a fully mobilized kidney offer better surgical exposure during the operation.
authors.affiliation: Department of Urology, The First Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, Zhejiang Province, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Wang
authors.affiliation: Department of Urology, The First Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, Zhejiang Province, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Xia
authors.affiliation: Department of Urology, Ningbo First Hospital, the Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Ma
authors.affiliation: Department of Urology, The First Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, Zhejiang Province, China. Electronic address: shuowang11@hotmail.com.
authors.forename: Shuo
authors.initials: S
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D015331:Cohort Studies; D003251:Constriction, Pathologic / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007668:Kidney / Q000002:abnormalities* / Q000601:surgery; D007682:Kidney Pelvis / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D061646:Operative Time; D061214:Patient Safety; D012187:Retroperitoneal Space; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000175:diagnosis / Q000601:surgery*; D014564:Urogenital Abnormalities / Q000175:diagnosis / Q000601:surgery; D055815:Young Adult