Laparoscopic Ureteroneocystostomy: Be Prepared!
Nicolas Bourdel1, Stephanie Cognet1, Michel Canis2
1Department of Gynecological Surgery, CHU Estaing Clermont Ferrand, Clermont-Ferrand, France.
Study Objective:
To assess the outcomes and complications of laparoscopic ureteroneocystotomy in gynecologic surgery.
Design:
We retrospectively reviewed all medical records of patients who underwent ureteroneocystostomy between April 2008 and May 2012.
Design Classification:
Retrospective case series study.
Setting:
A university tertiary care hospital.
Patients:
Nine patients underwent ureteroneocystostomy: 3 patients had ureteral endometriosis stenoses; and 6 patients had iatrogenic ureter injuries.
Interventions:
All procedures were performed laparoscopically. The ureterovesical re-implantation was unilateral in 8 cases and bilateral for 1 patient.
Measurements And Main Results:
The mean operating time was 226.7 min (range, 120-480). Average blood loss was 114.4 mL (range, 30-400). The mean duration of the in-dwelling catheter was 10.4 days (range, 7-21); the average hospital stay was 12.6 days (range, 6-26). The mean duration of the ureteral double J stent was 7.8 weeks (range, 6-16). One patient was re-operated for vaginal and laparoscopic drainage of a pelvic abscess on the sixth postoperative day. The median follow-up time was 20.8 months (range, 9-36), No patient had stenosis or breakdown of a suture line.
Conclusions:
Our series confirms the feasibility and the effectiveness of laparoscopic ureteroneocystostomy. This minimally invasive approach, which avoids laparotomy, requires a multidisciplinary team.
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