Robot-assisted Laparoscopic Dismembered Pyeloplasty for Ureteropelvic Junction Obstruction: A Multi-institutional Experience

    Authors

    A. Sivaraman; R. J. Leveillee; M. B. Patel; S. Chauhan; J. E. Bracho; C. R. Moore; R. F. Coelho; K. J. Palmer; O. Schatloff; V. G. Bird; R. Munver;V. R. Patel

    Comments

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    Abbreviated Journal Title

    Urology

    Keywords

    GOLD STANDARD; COMPLICATIONS; SYSTEM; Urology & Nephrology

    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.

    Journal Title

    Urology

    Volume

    79

    Issue/Number

    2

    Publication Date

    1-1-2012

    Document Type

    Article

    Language

    English

    First Page

    351

    Last Page

    355

    WOS Identifier

    WOS:000300407200040

    ISSN

    0090-4295

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