Laparoscopic pyeloplasty: the updated McMaster University experience

Authors

  • Jihao Dong Medical Student, McMaster University, St. Joseph’s Hospital, Hamilton, Ont.
  • Jaime Wong Fellow, Division of Urology, St. Joseph’s Hospital, Hamilton, Ont.
  • Ahmad Al-Enezi Resident, Division of Urology, St. Joseph’s Hospital, Hamilton, Ont.
  • Anil Kapoor Associate Professor, McMaster University, St. Joseph’s Hospital, Hamilton, Ont.
  • J. Paul Whelan Associate Professor, McMaster University, St. Joseph’s Hospital, Hamilton, Ont.
  • Kevin Piercey Associate Professor, McMaster University, St. Joseph’s Hospital, Hamilton, Ont.
  • Edward D. Matsumoto Assistant Professor, McMaster University, St. Joseph’s Hospital, Hamilton, Ont.

DOI:

https://doi.org/10.5489/cuaj.806

Abstract

Objective: The open Anderson–Hynes procedure has an overall success rate of 90% for ureteropelvic junction obstruction. Laparoscopic pyeloplasty (LP) was developed to reduce morbidity and hospital stay while preserving the excellent results. We report on the results of our experience with laparoscopic pyeloplasty.

Methods: Between January 2001 and May 2006, 77 consecutive patients underwent LP performed by one of 4 surgeons at our institution. Patients were reassessed with ultrasound (U/S) or intravenous pyelogram (IVP) at 6 weeks. Diuretic renal scan and U/S or IVP were performed at 6 months, and subsequent follow-up included a U/S or IVP as well as clinical assessment. Patients were assessed for pain and hydronephrosis on radiologic imaging, clearance on diuretic renal scan (T1/2) and differential renal function.

Results: We evaluated 73 patients. The mean patient age was 38 years (range 16–71 yr), the mean operating time was 218 minutes (range 110–409 min), and the mean blood loss was 57 mL (range 25–250 mL). Mean hospital stay was 3.0 days (range 2–7 d). The success rate was 90.4%, and failures were mainly due to poor function after surgery (3 patients). Pyelolithotomy was performed concomitantly on 6 patients, which on average extended operative time by 36 minutes.

Conclusion: Our success rates are consistent with the LP experience of other centres and are comparable with rates for the open technique. Patients had short hospital stays, and complications were negligible. With experienced surgeons, LP should be the first-line treatment for ureteropelvic junction obstruction.

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How to Cite

Dong, J., Wong, J., Al-Enezi, A., Kapoor, A., Whelan, J. P., Piercey, K., & Matsumoto, E. D. (2013). Laparoscopic pyeloplasty: the updated McMaster University experience. Canadian Urological Association Journal, 2(4), 388–92. https://doi.org/10.5489/cuaj.806

Issue

Vol. 2 No. 4 (2008): CUAJ August

Section

Original Research

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