Login to Access Video or Poster Abstract: MP24-08
Sources of Funding: none

Introduction

Laparoscopic pyeloplasty (LP) after failed open repair of uretreopelvic junction obstruction (UPJO), although a challenging reconstructive endeavor, is increasingly reported. We retrospectively review our experience and midterm results of LP for patients who have failed open pyeloplasty in comparison with those who had primary LP

Methods

Preoperative, intaroperative and postoperative data of 32 patients who had transperitoneal dismemebered LP after failed open pyeloplasty were reviewed. All procedures were performed by two experienced laparoscopists during the period from March 2009 to June 2013. Surgical outcomes were compared to those in 72 patients who underwent primary LP carried out by the same surgeons during the same study period.

Results

The study group consisted of 14 men and 18 women with the mean age of 29± 6 years. Mean operative time was 186± 57 and 123± 22 minutes in the secondary and primary LP groups, respectively. Mean hospital stay was 4.7 ± 2.3 and 4.3 ± 2.1 days in the two groups, respectively. Mean follow-up was 36 ± 11.2 months (range 24-72 months). The overall success rate for secondary LP was 90.6% compared to 94.4% in the primary LP group. There was no conversion to open surgery in both groups. Intraoperative and postoperative complications in secondary and primary LP were 9.4 and 12.5% versus 0 and 5.6% in both groups, respectively.

Conclusions

LP is a safe and viable treatment option for secondary uretreopelvic junction obstruction with a success rate similar to that of primary repair but with longer operative time and higher complication rate. A good experience in laparoscopic reconstructive procedures is a prerequisite for optimal results.

Funding

none