title: Robot-assisted pyeloplasty and pyelolithotomy in patients with ureteropelvic junction stenosis.
abstract: OBJECTIVE
  Approximately one in five patients with ureteropelvic junction stenosis (UPJS) also present with renal or ureteral stones. For patients with UPJS, the European Association of Urology guidelines currently recommend that robot-assisted pyeloplasty (RAP) and pyelolithotomy are performed as two separate procedures. The aim of the present study was to evaluate the feasibility and safety of RAP with concomitant pyelolithotomy (RAP + P) in patients diagnosed with UPJS and renal stones.
  
  
  METHODS
  In total, 56 RAP procedures and 18 RAP + P procedures were performed between December 2012 and January 2014. Patient records were retrospectively reviewed for operation time (OT), estimated blood loss (EBL), length of hospital stay (LOS), complications, stone burden and stone-free rates at 1, 3 and 6 months following surgery.
  
  
  RESULTS
  A significant difference in the OT was demonstrated between RAP and RAP + P, with a median of 120 min [interquartile range (IQR) 100-134 min] and 151 min (IQR 128-185 min), respectively (p < 0.0001). In contrast, no difference in LOS [median 2 days (IQR 2-3 days) vs 3 days (2-4 days), p = 0.50) or EBL [median 0 ml (IQR 0-50 ml) vs 20 ml (0-50 ml), p = 0.64] was observed between RAP and RAP + P. The median total stone burden was 1.5 cm (IQR 1.0-4.3 cm; range 1-10 cm). The stone-free rate at 1, 3 and 6 months was 94%, 83% and 72%, respectively. No grade 3-5 complications were observed in the RAP + P group.
  
  
  CONCLUSIONS
  RAP + P can safely be offered to patients with UPJS and renal stones, with an acceptable stone-free rate.
authors.affiliation: a Department of Urology , Zealand University Hospital , Roskilde , Denmark.
authors.forename: Pernille Hammershøj
authors.initials: PH
authors.lastname: Jensen
authors.affiliation: a Department of Urology , Zealand University Hospital , Roskilde , Denmark.
authors.forename: Kasper Drimer
authors.initials: KD
authors.lastname: Berg
authors.affiliation: a Department of Urology , Zealand University Hospital , Roskilde , Denmark.
authors.forename: Nessn H
authors.initials: NH
authors.lastname: Azawi
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D003251:Constriction, Pathologic / Q000150:complications / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000150:complications / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome; D014513:Ureter / Q000473:pathology / Q000601:surgery; D014514:Ureteral Calculi / Q000150:complications / Q000601:surgery*; D014517:Ureteral Obstruction / Q000150:complications / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000379:methods
keywords: Pyelolithotomy; pyeloplasty; renal pelvis stone; renal stones; robot assisted; ureteropelvic junction stenosis