TITLE:
Laparoscopic Transperitoneal Pyeloplasty for Ureteropelvic Junction Obstruction: Preliminary Results from 26 Cases
AUTHORS:
Cyril Kamadjou, Divine Enoru Eyongeta, Annie Kameni Wadeu, Patrick Fotso Gwabap, Bertin Njinou Ngninkeu, Edouard Hervé Moby
KEYWORDS:
Pyelo-Ureteral Junction, Lower Pole Vessel, Pyeloplasty, Double J Stent
JOURNAL NAME:
Surgical Science,
Vol.14 No.5,
May
16,
2023
ABSTRACT: Background and Objectives: Pyelo-Ureteral Junction Syndrome (PUJS) is the most common obstructive malformation of the upper urinary tract
in children and adults. The standard
treatment is open pyeloplasty using the Kuss-Anderson technique. Because of the minimally invasive nature of the laparoscopic
approach, it has become the approach of choice for the management of this
pathology. We present the results of
laparoscopic transperitoneal pyeloplasty used in the management of PUJS. Materials and Methods: This was a retrospective study
from 2015 to 2020, including 26 patients who underwent laparoscopic transperitoneal pyeloplasty for PUJS. Results: Twenty-six patients,
including 18 (69.2%) men and 6 (30.8%) women, with a mean age of 35.42 ± 13.62
years, were treated. Renal colic was the primary symptom in the majority of the cases (22, 84.6%)). The diagnosis was confirmed in all patients through an abdominal CT scan, which revealed that all 26 patients had
hydronephrosis. Half of the patients (50.0%) were classified as Valayer-Cendron
Type II, and eight (30.8%) patients had associated stones.
Seventeen (65.4%) patients had pathologies on the left side, and all patients
were treated using the Kuss-Anderson technique with a median operating time of
108.5 (90.0 - 136.0) minutes. The uncrossing of lower pole vessels was performed in 10
patients. The average duration of hospitalisation was 2.23 ± 0.82 days. No
conversion was observed, and after an average follow-up of 53.69 days, the success rate was 92.3%. Conclusion: Laparoscopic pyeloplasty is a minimally invasive technique of choice for the treatment of pyelo-ureteral
junction obstruction. It is dependable,
repeatable, and produces good functional outcomes that are equal to
those of traditional surgery.