Burak TURNA, Bülent SEMERCİ, Emil MUKHTAROV, Yavuz Selim SURAL, Caner ALPTEKİN, Erdal APAYDIN

Laparoskopik pyeloplasti: Teknik ve ön-sonuçlar

Biz bu çalışmada üreteropelvik bileşke darlığında transperitoneal laparoskopik pyeloplastinin yapılabilirliliğini, kendi tekniğimizi ve ön sonuçlarımızı rapor etmekteyiz. Kliniğimizde çaprazlayan damarı olan veya olmayan ÜP bileşke darlığına bağlı semptomatik hidronefrozu olan 11 hastaya laparoskopik pyeloplasti operasyonu yapıldı. Bütün hastalarda dismembered Anderson–Hynes pyeloplasti tekniği uygulandı. Bütün operasyonlar transperitoneal yoldan yapıldı. Bütün operasyonlar açık operasyona geçilmeden başarılı bir şekilde tamamlandı. Ortanca operasyon süresi ve kan kaybı sırasıyla 180 dakika (150–300) ve 135 ml (100–200) olarak saptandı. Beş hastada çaprazlayan damar varlığı gözlendi. Hiçbir has-tada intraoperatif veya postoperatif komplikasyon görülmedi. Ortanca hastanede kalış süresi 5 gün (2-7) ve morfin eşdeğe-ri analjezik kullanımı 10 mg’dı (5-20). Ortanca takip süresi 2 aydı (1-6). Laparoskopik pyeloplasti teknik olarak zor bir işlem olsa da güvenli ve başarılı bir şekilde yapılabilinir. ÜP bileşke darlığının tedavisinde açık cerrahiye değerli bir alter-natiftir.

Anahtar Kelimeler:

Tomografi, x-ışınlı bilgisayarlı, Laparoskopi, Üreter tıkanması, Böbrek pelvisi, Ürolojik cerrahi prosedürler

Laparoscopic pyeloplasty: Technic and early results

We have report the feasibility of transperitoneal laparoscopic pyeloplasty for UPJ obstruction and describe our technique and report the preliminary outcomes of our initial cases. Laparoscopic pyeloplasty was performed 11 patients presenting with symptomatic hydronephrosis secondary to UPJ obstruction with or without anterior crossing vessels. We performed dismembered Anderson–Hynes pyeloplasty in all patients. All procedures were carried out transperitoneally. The procedure was completed successfully without open conversion in all cases. Median operative time and blood loss were 180 minutes (range 150–300) and 135 ml (range 100–200), respectively. Crossing vessels were noted in 5 patients. There were no intraoperative or postoperative complications. Median hospital stay was 5 days (range 2-7) and morphine equivalent analgesic use was 10 mg (range 5-20). Median follow up was 2 months (1-6). Although the procedure requires advanced laparoscopic skills, it can be safely and successfully completed laparoscopically. Laparoscopic pyeloplasty appears to be a valuable alternative to open pyeloplasty for UPJ obstruction.

Keywords:

Tomography, X-Ray Computed, Laparoscopy, Ureteral Obstruction, Kidney Pelvis, Urologic Surgical Procedures,

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