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Paper Information

Title: 

LAPAROSCOPICALLY ASSISTED PYELO-URETERO-CYSTOPLASTY

Type: PAPER
Author(s): BASIRI ABBAS*,SHADPOUR PEJMAN,MAGSUDI RAZIEH
 
 *
 
Name of Seminar: CONGREH ANJOMAN UROLOGY IRAN
Type of Seminar:  CONGRESS
Sponsor:  ANJOMAN OROLOGY
Date:  2005Volume 8
 
 
Abstract: 

PROPOSE: LAPAROSCOPY IS UTILIZED TO AVOID THE LARGE MIDLINE OR FLANK INCISION REQUIRED FOR LEFT NEPHRECTOMY AS PRECLUDE TO OPEN PYELO-URETERO-CYSTOPLASTY. WE REPORT A CASE WITH RECURRENT FEBRILE URINARY TRACT INFECTION TREATED WITH LAPAROSCOPICALLY ASSISTED PYELO-URETERO-CYSTOPLASTY.
METHODS & MATERIALS: THE PATIENT WAS A NINE-YEAR-OLD FEMALE WITH RECURRENT FEBRILE URINARY TRACT INFECTION, AFFLICTED WITH NEUROPATHIC BLADDER DYSFUNCTION AND BILATERAL REFLUX (LEFT GRADE 5 AND RIGHT GRADE 4). SINCE ONLY 9.2% OF HER RENAL FUNCTION CAME FROM THE LEFT KIDNEY, WE CHOSE TO PERFORM LAPAROSCOPIC LEFT NEPHRECTOMY THROUGH TWO 12MM PORTS (I.E. UMBILICAL AND PARARECTUS), AND ONE 5MM EPIGASTRIC ACCESS. RENAL VASCULAR CLAMPING AND CUTTING WAS DONE AND KIDNEY AND URETER WAS PUSHED TO THE PELVIC SPACE; THEN IT WAS REMOVED THROUGH A PFANNENSTIEL INCISION. AFTER REMOVING OF PARENCHYMA, THE PELVIS AND URETER WERE DETUBULARIZED AND REFASHIONED INTO A SPIRAL CAP IN CONTINUITY WITH THE VESICAL JUNCTION. THIS PATCH WAS THEN ANASTOMOSED TO THE SAGITTALLY CLEAVED BLADDER DOME. SHE WAS DISCHARGED IN EXCELLENT CONDITION ON THE FOURTH POSTOPERATIVE DAY.
RESULTS: AT 2.5 MONTHS FOLLOW-UP, THE BLADDER CAPACITY HAS RISEN TO 320ML, FROM 200ML PREOPERATIVELY. HER URINE IS STERILE, AND RENAL FUNCTION IS STABLE ON PROPHYLAXIS AND INTERMITTENT CATHETERIZATION EVERY 4 HOURS. THE RIGHT-SIDED REFLUX HAS GROSSLY IMPROVED TO LESS THAN GRADE 2.
DISCUSSION & CONCLUSION: LAPAROSCOPICALLY ASSISTED PYELO-URETERO-CYSTOPLASTY HAS PROVIDED THE OPPORTUNITY TO AVOID OPEN FLANK SURGERY, AND PRACTICALLY CIRCUMVENT THE MORBIDITY OF ENTEROCYSTOPLASTY.

 
Keyword(s): LAPAROSCOPY, PYELO-URETERO-CYSTOPLASTY
 
 
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