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Title: | Robot-assisted Laparoscopic Dismembered Pyeloplasty for Ureteropelvic Junction Obstruction: A Multi-institutional Experience |
Authors: | SIVARAMAN, Ananthakrishnan; LEVEILLEE, Raymond J.; PATEL, Manoj B.; CHAUHAN, Sanket; II, Jorge E. Bracho; MOORE, Charles R.; COELHO, Rafael F.; PALMER, Kenneth J.; SCHATLOFF, Oscar; BIRD, Vincent G.; MUNVER, Ravi; PATEL, Vipul R. |
Citation: | UROLOGY, v.79, n.2, p.351-355, 2012 |
Abstract: | OBJECTIVE To report a 6-year multi-institutional experience and outcomes with robot-assisted laparoscopic pyeloplasty (RLP) for the repair of ureteropelvic junction obstruction (UPJO). PATIENTS AND METHODS Between June 2002 and October 2008, 168 adult patients from 3 institutions underwent RLP for UPJO. A retrospective analysis of prospectively collected data were performed after institutional review board approval. Diagnosis was by intravenous urogram or computed tomography scan and diuretic renogram. All patients underwent RLP through a 4-port laparoscopic technique. Demographic, preoperative, operative, and postoperative endpoints for primary and secondary repair of UPJO were measured. Success was defined as a T-1/2 of <20 minutes on diuretic renogram and symptom resolution. Pain resolution was assessed by subjective patient reports. RESULTS Of 168 patients, 147 (87.5%) had primary repairs and 21 (12.5%) had secondary repairs. Of the secondary repairs, 57% had a crossing vessel etiology. Mean operative time was 134.9 minutes, estimated blood loss was 49 mL, and length of stay was 1.5 days. Mean follow-up was 39 months. Overall, 97.6% of patients had a successful outcome, with a 6.6% overall complication rate. CONCLUSIONS To our knowledge, this review represents the largest multi-institutional experience of RLP with intermediate-term follow-up. RLP is a safe, efficacious, and viable option for either primary or secondary repair of UPJO with reproducible outcomes, a high success rate, and a low incidence of complications. UROLOGY 79: 351-355, 2012. (C) 2012 Elsevier Inc. |
Appears in Collections: | Artigos e Materiais de Revistas Científicas - HC/ICESP |
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