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