Department of Urology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey.
J Endourol. 2022 Nov;36(11):1425-1430. doi: 10.1089/end.2022.0135. Epub 2022 Sep 27.
To compare the surgical outcomes of open and laparoscopic ureterolysis procedures in patients requiring surgical treatment for ureteral obstruction caused by retroperitoneal fibrosis (RPF). This study was designed retrospectively. The clinical records of patients who underwent ureterolysis between January 2005 and April 2019 because of ureteral obstruction caused by RPF were examined. According to the type of surgery, the patients were divided into two groups as Group 1 (open ureterolysis) and Group 2 (laparoscopic ureterolysis). Demographic features, preoperative-postoperative renal functions, duration of follow-up with ureteral stents, and perioperative-postoperative complications were examined. The requirement of ureteral stent placement during the follow-up period was accepted as unsuccessful ureterolysis. Ureterolysis was performed in 13 patients and 23 renal units. Eleven of these patients were men and two were women. The median age of the patients was 54 (44-68) years. There were six patients and 12 renal units in Group 1 and seven patients and 11 renal units in Group 2. Postoperatively, a total of four patients (30%) had minor complications (Clavien-Dindo 1-2) and one patient had a major complication (Clavien-Dindo 3a). Ureterolysis was determined to be effective in 21 of the renal units (91%) [11/12 (92%) in Group 1 10/11 (91%) in Group 2]. No statistically significant difference was found between the groups in terms of the success and complication rates ( = 1 and = 0.529, respectively). Postoperative hospitalization length and recovery time to return to normal preoperative activities were significantly shorter in Group 2 than in Group 1 ( = 0.011 and = 0.041, respectively). The success and complication rates were similar between the open and laparoscopic methods for ureterolysis. Laparoscopic approach was advantageous over open approach in terms of postoperative hospitalization length and recovery time to return to normal preoperative activities.
比较开放和腹腔镜输尿管松解术治疗因腹膜后纤维化（RPF）引起的输尿管梗阻患者的手术效果。本研究为回顾性研究。检查了 2005 年 1 月至 2019 年 4 月因 RPF 引起的输尿管梗阻而行输尿管松解术的患者的临床记录。根据手术类型，将患者分为两组，组 1（开放输尿管松解术）和组 2（腹腔镜输尿管松解术）。检查了人口统计学特征、术前-术后肾功能、输尿管支架随访时间以及围手术期-术后并发症。输尿管支架在随访期间的放置需求被认为是输尿管松解术不成功。13 例患者 23 个肾脏单位行输尿管松解术。其中 11 例为男性，2 例为女性。患者的中位年龄为 54（44-68）岁。组 1 有 6 例患者 12 个肾脏单位，组 2 有 7 例患者 11 个肾脏单位。术后共有 4 例（30%）患者出现轻微并发症（Clavien-Dindo 1-2），1 例患者出现严重并发症（Clavien-Dindo 3a）。21 个肾脏单位（91%）[组 1 11/12（92%），组 2 10/11（91%）]认为输尿管松解术有效。两组在成功率和并发症发生率方面无统计学差异（ = 1 和 = 0.529）。与组 1 相比，组 2 的术后住院时间和恢复正常术前活动的时间明显缩短（ = 0.011 和 = 0.041）。开放和腹腔镜输尿管松解术的成功率和并发症发生率相似。腹腔镜方法在术后住院时间和恢复正常术前活动的时间方面优于开放方法。
