Laparoscopic plasty in primary stricture of pyeloureteral segment


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Abstract

The article presents the results of laparoscopic pyeloplasty in 72 patients with primary stricture of pyeloureteral segment (PUS). The study included 34 men, 38 women; mean age was 32±4,6 years. The operation was performed by transperitoneal approach in side position of patients. 4 trocars were used. There were no conversions to open surgery. Urinary leak after surgery was observed in 4 patients; in 3 patients it has discontinued independently, and in one patient it has required a repeat laparoscopy and suturing of anastomotic defect. Due to recurrent narrowing of the PUS, two patients underwent retrograde endopyelotomy, and one patient - open pyeloplasty. The effectiveness of laparoscopic pyeloplasty in these series was 94,4 %. Impediments for performing laparoscopic pyeloplasty included small pelvis size, the presence of inferior polar vessels, and frequent exacerbations of chronic pyelonephritis, which led to the development of adhesive process in the PUS. Thus, laparoscopic pyeloplasty is the treatment of choice in patients with primary constrictions of PUS and is as effective as open plasty of PUS.

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