Retroperitoneal laparoscopic reconstruction for retrocaval ureter: experience and literature review.

PURPOSE

We describe surgical techniques and experience with retroperitoneal laparoscopic pyeloureterostomy in five cases of retrocaval ureter (RU). We also report the laparoscopic approach reconstruction for RU from peer-reviewed publications.

PATIENTS AND METHODS

Five patients with RU underwent retroperitoneal laparoscopic pyeloureterostomy. Nuclear renography, intravenous urography (IVU), and ultrasonography follow-up was performed postoperatively. Science Citation Index searches were conducted to identify laparoscopic reconstruction for RU outcomes. Studies published after 1994 were included in the analysis.

RESULTS

Operations were completed successfully and without complications in five patients. The mean operative time was 90.2 ± 34.4 minutes. The mean time needed to insert the Double-J stent and reanastomosis was 51.2 ± 11.4 minutes. Blood loss was minimal. Over a follow-up of 12 to 37 months, hydronephrosis was found to decrease substantially. There were 24 peer-reviewed studies covering a total of 62 patients suitable for inclusion in our final analysis. The most common method for reconstruction of the ureter was ureteroureterostomy, followed by pyeloureterostomy and pyelopyelotomy.

CONCLUSION

Retroperitoneal laparoscopy for RU is a safe and effective procedure that should be considered as a first-line treatment for patients with this anatomic anomaly.