1 Urology Unit, AORN Cardarelli Hospital , Naples, Italy .
J Endourol. 2013 Oct;27(10):1224-9. doi: 10.1089/end.2013.0301. Epub 2013 Sep 18.
To describe and analyze a single surgical team's experience with intraoperative and postoperative complications arising from the Anderson-Hynes transperitoneal laparoscopic pyeloplasty (LP) procedure in the treatment of patients with ureteropelvic junction obstruction (UPJO).
There were 236 consecutive patients who underwent transperitoneal LP over a period of 8 years (2004-2012). These patients' records were retrospectively analyzed for intraoperative and postoperative complications. Of the 236 patients, 111 (47.0%) were males and 125 (53%) were females. In 226 patients, surgical indication was primary UPJO, and in 10 patients, recurrent obstruction. Two hundred and eleven patients (89.4%) were symptomatic.
Mean operative time was 96.5 minutes (range 45-360 min). The mean blood loss was 20 mL (range 5-500 mL), and no blood transfusions were necessary. The overall success rate was 97% (229 patients) with a mean follow-up of 38 months (range 6-84 mos). In 86 of the 94 patients who presented with a crossing vessel (91.5%), the anomalous crossing vessel was transposed to the ureteropelvic junction (UPJ) dorsally because of evident obstruction. The mean postoperative hospital stay was 4.2 days (range 3-14 days). All 211 preoperative symptomatic patients reported a complete resolution of symptoms after the procedure. Intraoperative incidents occurred in nine (3.8%) patients, while postoperative complications occurred in 32 (13.5%) patients.
Our retrospective analysis confirms that LP is an efficacious and safe procedure resulting in a reported success rate of 97% and a concomitant low level of intraoperative (3.8%) and postoperative complications (13.6%). Major complications necessitating active management occur in a low percentage of cases (5.9% of patients). The most frequent and severe intraoperative complications are related to the Double-J stent insertion. The most common postoperative complication is urine leakage.
描述并分析一个外科手术团队在经腹腔腹腔镜Anderson-Hynes肾盂成形术（LP）治疗肾盂输尿管连接部梗阻（UPJO）患者的术中及术后并发症的经验。
对 8 年内（2004 年至 2012 年）接受经腹腔 LP 的 236 例连续患者的记录进行回顾性分析，以确定术中及术后并发症。236 例患者中，男性 111 例（47.0%），女性 125 例（53%）。226 例患者的手术指征为原发性 UPJO，10 例为复发性梗阻。211 例患者（89.4%）有症状。
平均手术时间为 96.5 分钟（45-360 分钟）。平均失血量为 20ml（5-500ml），无需输血。总体成功率为 97%（229 例），平均随访 38 个月（6-84 个月）。在 94 例有交叉血管的患者中，86 例（91.5%）因明显梗阻，将异常交叉血管向肾盂输尿管连接部（UPJ）背侧移位。术后平均住院时间为 4.2 天（3-14 天）。所有 211 例术前有症状的患者在手术后症状完全缓解。9 例（3.8%）患者术中发生意外事件，32 例（13.5%）患者术后发生并发症。
我们的回顾性分析证实，LP 是一种有效且安全的手术，成功率为 97%，术中（3.8%）和术后并发症（13.6%）发生率低。需要积极处理的严重并发症发生率较低（5.9%的患者）。最常见和最严重的术中并发症与双 J 支架置入有关。最常见的术后并发症是尿漏。
