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Comparative Study Between Anderson-Hynes Pyeloplasty Through Transperitoneal Laparoscopic Approach Versus Vertical Lumbotomy Approach in UPJO Repair

Received: 29 October 2021    Accepted: 4 January 2022    Published: 28 January 2022
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Abstract

Background: Since 1949 dismembered pyeloplasty technique which was introduced by Anderson and Hynes has been the gold standard for the surgical correction of UPJO. And for decades Laparoscope has been the preferred approach. However, in Egypt - like many other developing countries- there is a limitation of laparoscopic interventions due to the limited number and distribution of laparoscopic sets. This limited availability forced many urologists in general hospitals to refer UPJO patients to tertiary centers and university hospitals, which added more burden on the already exhausted facilities. Objective: In this paper, we tried to explore options available to urologists who are working in areas where laparoscopic sets aren’t available. We suggested the vertical lumbotomy approach to be explored in this study. Method: The study was conducted at El Demerdash Hospital in 2016. It included 20 patients with symptomatic UPJO. Patients were allocated to the 2 groups, 10 patients each using the closed envelop method. Results: Significantly shorter hospital stay in the vertical lumbotomy group. No statistically significant differences were noted between the studied group regarding postoperative pain, frequency of irritative LUS, hematuria, and pyuria. Study limitations: There were limitations of the study that might have affected its results such as the experience caliber of both teams, there were no unified preset criteria for post-operative management and there wasn't enough data about the learning curve of each approach. Conclusion: The laparoscopic approach for correction of UPJO is still the gold standard, however in some areas in developing countries which might be deprived of enough laparoscopic sets, the vertical lumbotomy approach can be utilized after proper training. This study results shouldn't be applied in hospitals where the laparoscopic approach is established for UPJO surgery.

Published in International Journal of Clinical Urology (Volume 6, Issue 1)
DOI 10.11648/j.ijcu.20220601.14
Page(s) 15-18
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

UPJO, Laparoscopic, Vertical Lumbotomy

References
[1] Khan F, Ahmed K, Lee N, Challacombe B, Khan MS, Dasgupta P. Management of ureteropelvic junction obstruction in adults. Nat Rev Urol. 2014 Nov; 11 (11): 629-38.
[2] Habibi HA, Cicek RY, Kandemirli SG, Ure E, Ucar AK, Aslan M, Caliskan S, Adaletli I. Acoustic radiation force impulse (ARFI) elastography in the evaluation of renal parenchymal stiffness in patients with ureteropelvic junction obstruction. J Med Ultrason (2001). 2017 Apr; 44 (2): 167-172. doi: 10.1007/s10396-016-0760-7. Epub 2016 Dec 8. PMID: 27933438.
[3] Lawler LP, Jarret TW, Corl FM, Fishman EK. Adult ureteropelvic junction obstruction: insights with three-dimensional multi-detector row CT. Radiographics. 2005 Jan-Feb; 25 (1): 121-34.
[4] Braun P, Guilabert JP, Kazmi F. Multidetector computed tomography arteriography in the preoperative assessment of patients with ureteropelvic junction obstruction. Eur J Radiol. 2007 Jan; 61 (1): 170-5. doi: 10.1016/j.ejrad.2006.08.027. Epub 2006 Oct 17. PMID: 17049790.
[5] Ritter L, Götz G, Sorge I, Lehnert T, Hirsch FW, Bühligen U, Vieweger A, Geyer C. Significance of MR angiography in the diagnosis of aberrant renal arteries as the cause of ureteropelvic junction obstruction in children. Rofo. 2015 Jan; 187 (1): 42-8.
[6] Weiss DA, Kadakia S, Kurzweil R, Srinivasan AK, Darge K, Shukla AR. Detection of crossing vessels in pediatric ureteropelvic junction obstruction: Clinical patterns and imaging findings. J Pediatr Urol. 2015 Aug; 11 (4): 173. e1-5.
[7] Parikh KR, Hammer MR, Kraft KH, Ivančić V, Smith EA, Dillman JR. Pediatric ureteropelvic junction obstruction: can magnetic resonance urography identify crossing vessels? Pediatr Radiol. 2015 Nov; 45 (12): 1788-95.
[8] Pavicevic PK, Saranovic DZ, Mandic MJ, Vukadinovic VM, Djordjevic MLj, Radojicic ZI, Petronic I, Cirovic D, Nikolic D. Efficacy of Magnetic Resonance urography in detecting crossing renal vessels in children with ureteropelvic junction obstruction. Ann Ital Chir. 2015; 86: 443-9.
[9] Ekin RG, Celik O, Ilbey YO. An up-to-date overview of minimally invasive treatment methods in ureteropelvic junction obstruction. Cent European J Urol. 2015; 68 (2): 245-51.
[10] Kavoussi LR, Peters CA. Laparoscopic pyeloplasty. J Urol 1993; 150: 1891.
[11] Reddy MN, Nerli RB. The laparoscopic pyeloplasty: is there a role in the age of robotics? Urol Clin North Am. 2015 Feb; 42 (1): 43-52. doi: 10.1016/j.ucl.2014.09.004. Epub 2014 Oct 12. PMID: 25455171.
[12] Schuessler WW, Grune MT, Tecuanhuey LV, et al. Laparoscopic dismembered pyeloplasty. J Urol 1993; 150: 1795.
[13] Carr, Michael & Casale, Pasquale. (2012). Anomalies and Surgery of the Ureter in Children. Campbell-Walsh urology. 3212-3235. 10.1016/B978-1-4160-6911-9.00120-1.
[14] Yeung CK, Tam YH, Sihoe JD, et al. Retroperitoneo-scopic dismembered pyeloplasty for pelviureteric junction obstruction in infants and children. Br J Urol 2001; 87: 509.
[15] El Ghoneimi A, Farhat W, Bolduc S, et al. Laparo-scopic dismembered pyeloplasty by a retroperito-neal approach in children. BJU Int 2003; 92: 104.
[16] Reddy M, Nerli RB, Bashetty R, et al. Laparoscopic dismembered pyeloplasty in children. J Urol 2005; 174: 700–2.
[17] Halder P, Mukhopadhyay B, Mandal KC, et al. Dorsal Lumbotomy Approach for Pediatric Dismembered Pyeloplasty. Ped Health Res 2017, 2: 1.
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  • APA Style

    Yehia Hassan. (2022). Comparative Study Between Anderson-Hynes Pyeloplasty Through Transperitoneal Laparoscopic Approach Versus Vertical Lumbotomy Approach in UPJO Repair. International Journal of Clinical Urology, 6(1), 15-18. https://doi.org/10.11648/j.ijcu.20220601.14

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    ACS Style

    Yehia Hassan. Comparative Study Between Anderson-Hynes Pyeloplasty Through Transperitoneal Laparoscopic Approach Versus Vertical Lumbotomy Approach in UPJO Repair. Int. J. Clin. Urol. 2022, 6(1), 15-18. doi: 10.11648/j.ijcu.20220601.14

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    AMA Style

    Yehia Hassan. Comparative Study Between Anderson-Hynes Pyeloplasty Through Transperitoneal Laparoscopic Approach Versus Vertical Lumbotomy Approach in UPJO Repair. Int J Clin Urol. 2022;6(1):15-18. doi: 10.11648/j.ijcu.20220601.14

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  • @article{10.11648/j.ijcu.20220601.14,
      author = {Yehia Hassan},
      title = {Comparative Study Between Anderson-Hynes Pyeloplasty Through Transperitoneal Laparoscopic Approach Versus Vertical Lumbotomy Approach in UPJO Repair},
      journal = {International Journal of Clinical Urology},
      volume = {6},
      number = {1},
      pages = {15-18},
      doi = {10.11648/j.ijcu.20220601.14},
      url = {https://doi.org/10.11648/j.ijcu.20220601.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcu.20220601.14},
      abstract = {Background: Since 1949 dismembered pyeloplasty technique which was introduced by Anderson and Hynes has been the gold standard for the surgical correction of UPJO. And for decades Laparoscope has been the preferred approach. However, in Egypt - like many other developing countries- there is a limitation of laparoscopic interventions due to the limited number and distribution of laparoscopic sets. This limited availability forced many urologists in general hospitals to refer UPJO patients to tertiary centers and university hospitals, which added more burden on the already exhausted facilities. Objective: In this paper, we tried to explore options available to urologists who are working in areas where laparoscopic sets aren’t available. We suggested the vertical lumbotomy approach to be explored in this study. Method: The study was conducted at El Demerdash Hospital in 2016. It included 20 patients with symptomatic UPJO. Patients were allocated to the 2 groups, 10 patients each using the closed envelop method. Results: Significantly shorter hospital stay in the vertical lumbotomy group. No statistically significant differences were noted between the studied group regarding postoperative pain, frequency of irritative LUS, hematuria, and pyuria. Study limitations: There were limitations of the study that might have affected its results such as the experience caliber of both teams, there were no unified preset criteria for post-operative management and there wasn't enough data about the learning curve of each approach. Conclusion: The laparoscopic approach for correction of UPJO is still the gold standard, however in some areas in developing countries which might be deprived of enough laparoscopic sets, the vertical lumbotomy approach can be utilized after proper training. This study results shouldn't be applied in hospitals where the laparoscopic approach is established for UPJO surgery.},
     year = {2022}
    }
    

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  • TY  - JOUR
    T1  - Comparative Study Between Anderson-Hynes Pyeloplasty Through Transperitoneal Laparoscopic Approach Versus Vertical Lumbotomy Approach in UPJO Repair
    AU  - Yehia Hassan
    Y1  - 2022/01/28
    PY  - 2022
    N1  - https://doi.org/10.11648/j.ijcu.20220601.14
    DO  - 10.11648/j.ijcu.20220601.14
    T2  - International Journal of Clinical Urology
    JF  - International Journal of Clinical Urology
    JO  - International Journal of Clinical Urology
    SP  - 15
    EP  - 18
    PB  - Science Publishing Group
    SN  - 2640-1355
    UR  - https://doi.org/10.11648/j.ijcu.20220601.14
    AB  - Background: Since 1949 dismembered pyeloplasty technique which was introduced by Anderson and Hynes has been the gold standard for the surgical correction of UPJO. And for decades Laparoscope has been the preferred approach. However, in Egypt - like many other developing countries- there is a limitation of laparoscopic interventions due to the limited number and distribution of laparoscopic sets. This limited availability forced many urologists in general hospitals to refer UPJO patients to tertiary centers and university hospitals, which added more burden on the already exhausted facilities. Objective: In this paper, we tried to explore options available to urologists who are working in areas where laparoscopic sets aren’t available. We suggested the vertical lumbotomy approach to be explored in this study. Method: The study was conducted at El Demerdash Hospital in 2016. It included 20 patients with symptomatic UPJO. Patients were allocated to the 2 groups, 10 patients each using the closed envelop method. Results: Significantly shorter hospital stay in the vertical lumbotomy group. No statistically significant differences were noted between the studied group regarding postoperative pain, frequency of irritative LUS, hematuria, and pyuria. Study limitations: There were limitations of the study that might have affected its results such as the experience caliber of both teams, there were no unified preset criteria for post-operative management and there wasn't enough data about the learning curve of each approach. Conclusion: The laparoscopic approach for correction of UPJO is still the gold standard, however in some areas in developing countries which might be deprived of enough laparoscopic sets, the vertical lumbotomy approach can be utilized after proper training. This study results shouldn't be applied in hospitals where the laparoscopic approach is established for UPJO surgery.
    VL  - 6
    IS  - 1
    ER  - 

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Author Information
  • Urology Department Aldemerdash, Ain Shams University, Cairo, Egypt

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