CU 48. A feasibility analysis of re-angioplasty using transabdominal laparoscopic approach through the mesenteric for recurrent ureteropelvic junction obstruction (UPJO) patients (report of 5 Cases)

Objective: To evaluate the feasibility and safety of re-angioplasty using transabdominal laparoscopic approach through the mesenteric for recurrent ureteropelvic junction obstruction (UPJO) patients.

Methods: Select recurrence patients of ureteropelvic junction obstruction after open retroperitoneal angioplasty admitted to Department of Urology, Peking University First Hospital from May 2006 to June 2008 in 5 cases, of which 3 were male and 2 females, aged 19 to 32 years old. Their obstruction occurred 3 to 16 years after the operation with an average of 7.8 years. All the patients had some degrees of waist soreness discomfort, with imaging examination showed a typical UPJO and kidney renal dynamic scan showed slow emptying, and after injection furosemide (furosemide) showed varying degrees of emptying. Laparoscopic surgery using transabdominal approach through the mesenteric, longitudinal cut the mesangial and retroperitoneal at the mesenteric root near renal pedicle, revealed the ureteropelvic junction, and taken to avoid bowel and mesenteric injury. Cut off UPJO, continuous sutured renal plevis and ureter using Anderson- Hynes methods with two stitches.

Results: Operative time was 105-230 min, an average of 165 min; blood loss was 50-120 mL, an average of 75 mL. The patients could take off-bed activity 1 day after operation, and the drainage tubes were removed 3 to 4 days later. The intraoperative and postoperative vice damage and complications did not occur. As of October 2010, follow-up lasted 33 to 49 months (an average of 37.5 months), the imaging and diuretic renal dynamic examinations revealed smooth emptying of UPJ for all the patients.

Conclusions: For laparoscopic experienced surgeons, reangioplasty using transabdominal laparoscopic approach by the mesenteric for recurrent ureteropelvic junction obstruction patients is feasible, safe and effective. But for beginners are advised to carefully consider this surgical method.