title: Long-term follow-up results of laparoscopic pyeloplasty.
abstract: OBJECTIVE
  To assess the long-term follow-up results of laparoscopic pyeloplasty for ureteropelvic junction obstruction.
  
  
  METHODS
  Sixty-five patients (mean age, 43.8 years) who underwent standard laparoscopic pyeloplasty by transperitoneal approaches were enrolled in this study. The chief complaint was flank pain (n=57 patients); the remaining cases were detected incidentally. Twenty-three patients had undergone previous abdominal surgeries, including open pyeloplasty and endopyelotomy. Mean stricture length was 1.06 cm. Grade 3/4 and 4/4 hydronephrosis was detected in 36 and 14 patients, respectively. An obstructive pattern was present on the renal scan in 53 patients (81.5%).
  
  
  RESULTS
  Fifty-seven patients were treated with dismembered Anderson-Hynes pyeloplasty and eight patients with Fenger pyeloplasty. During the operation, crossing vessels were found in 27 patients (41.5%). Mean operating time was 159.42 minutes. Although there were no cases of open conversion, two patients with colon and spleen injuries were detected postoperatively. The mean starting time of postoperative ambulation and diet was 1.54 days and 1.86 days, respectively. Mean hospital stay was 8.09 days. Mean follow-up period was 36.5 months. Follow-up intravenous pyelography and renal scan showed improvements in 59 patients, and the radiologic success rate was 90.8%. Eight patients showed failure on radiologic or symptomatic evaluation, and the overall success rate was 87.7%. In the comparative analysis between the success and failure groups, drained amount was the only risk factor related to failure (554.41 mL. vs. 947.70 mL, p=0.024).
  
  
  CONCLUSIONS
  Long-term follow-up results support laparoscopic pyeloplasty as the standard treatment for ureteropelvic junction obstruction. Drained amount is a risk factor for failure of the operation.
authors.affiliation: Department of Urology, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea.
authors.forename: Ill Young
authors.initials: IY
authors.lastname: Seo
authors.affiliation: Department of Urology, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea.
authors.forename: Tae Hoon
authors.initials: TH
authors.lastname: Oh
authors.affiliation: Department of Urology, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea.
authors.forename: Jae Whan
authors.initials: JW
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006869:Hydronephrosis / Q000151:congenital* / Q000473:pathology / Q000601:surgery; D007682:Kidney Pelvis / Q000601:surgery; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D021782:Multicystic Dysplastic Kidney / Q000473:pathology / Q000601:surgery*; D012307:Risk Factors; D012720:Severity of Illness Index; D017211:Treatment Failure; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000473:pathology / Q000601:surgery*; D055815:Young Adult
keywords: Laparoscopy; Treatment failure; Ureteral obstruction