The Minimally Invasive Treatment of Ureteropelvic Junction Obstruction: A Review of Our Experience During the Last Decade

Brent V. Yanke, Costas D. Lallas, Christopher Pagnani, David E. McGinnis, Demetrius H. Bagley

Research output: Contribution to journalArticle

Abstract

Purpose: The minimally invasive treatment of ureteropelvic junction obstruction has evolved during the last decade from endoscopic to laparoscopic and robotic. We review our 10-year experience with ureteropelvic junction obstruction, and report on our experience and followup. Materials and Methods: We reviewed all patients treated during the last 10 years. There were 294 procedures performed with complete records on 273 patients including 128 retrograde endopyelotomies, 116 laparoscopic pyeloplasties and 29 robotic pyeloplasties. Technique for each procedure is reviewed. Statistical analysis was performed on all results. Variables evaluated were gender, age (younger than 41 vs 41 years or older), side (right or left), presence of crossing vessels, presence of a high insertion, primary or secondary procedure and whether prior endopyelotomy or pyeloplasty had been performed. Results: Mean followup for endopyelotomy, laparoscopic pyeloplasty and robotic pyeloplasty was 20, 20 and 19 months, respectively, with success rates of 60.2%, 88.8% and 100%, respectively. On univariable analysis only the presence of crossing vessels or a high insertion was significant for laparoscopic pyeloplasty. On multivariable analysis age was significant for endopyelotomy and the presence of crossing vessels was significant for pyeloplasty. On Kaplan-Meier analysis failures were noted to occur after 5 years in both groups. Conclusions: Laparoscopic pyeloplasty and robotic pyeloplasty are superior minimally invasive treatments for ureteropelvic junction obstruction. However, endopyelotomy can be used for select patients. Because of late failures patients who undergo either of these procedures should receive long-term followup.

Original languageEnglish (US)
Pages (from-to)1397-1402
Number of pages6
JournalJournal of Urology
Volume180
Issue number4
DOIs
StatePublished - Oct 2008
Externally publishedYes

Fingerprint

Robotics
Therapeutics
Kaplan-Meier Estimate

Keywords

  • laparoscopy
  • robotics
  • ureteral obstruction

ASJC Scopus subject areas

  • Urology

Cite this

The Minimally Invasive Treatment of Ureteropelvic Junction Obstruction : A Review of Our Experience During the Last Decade. / Yanke, Brent V.; Lallas, Costas D.; Pagnani, Christopher; McGinnis, David E.; Bagley, Demetrius H.

In: Journal of Urology, Vol. 180, No. 4, 10.2008, p. 1397-1402.

Research output: Contribution to journalArticle

Yanke, Brent V. ; Lallas, Costas D. ; Pagnani, Christopher ; McGinnis, David E. ; Bagley, Demetrius H. / The Minimally Invasive Treatment of Ureteropelvic Junction Obstruction : A Review of Our Experience During the Last Decade. In: Journal of Urology. 2008 ; Vol. 180, No. 4. pp. 1397-1402.
@article{eb0d7f8c58b04389b8483657ee6a91b3,
title = "The Minimally Invasive Treatment of Ureteropelvic Junction Obstruction: A Review of Our Experience During the Last Decade",
abstract = "Purpose: The minimally invasive treatment of ureteropelvic junction obstruction has evolved during the last decade from endoscopic to laparoscopic and robotic. We review our 10-year experience with ureteropelvic junction obstruction, and report on our experience and followup. Materials and Methods: We reviewed all patients treated during the last 10 years. There were 294 procedures performed with complete records on 273 patients including 128 retrograde endopyelotomies, 116 laparoscopic pyeloplasties and 29 robotic pyeloplasties. Technique for each procedure is reviewed. Statistical analysis was performed on all results. Variables evaluated were gender, age (younger than 41 vs 41 years or older), side (right or left), presence of crossing vessels, presence of a high insertion, primary or secondary procedure and whether prior endopyelotomy or pyeloplasty had been performed. Results: Mean followup for endopyelotomy, laparoscopic pyeloplasty and robotic pyeloplasty was 20, 20 and 19 months, respectively, with success rates of 60.2{\%}, 88.8{\%} and 100{\%}, respectively. On univariable analysis only the presence of crossing vessels or a high insertion was significant for laparoscopic pyeloplasty. On multivariable analysis age was significant for endopyelotomy and the presence of crossing vessels was significant for pyeloplasty. On Kaplan-Meier analysis failures were noted to occur after 5 years in both groups. Conclusions: Laparoscopic pyeloplasty and robotic pyeloplasty are superior minimally invasive treatments for ureteropelvic junction obstruction. However, endopyelotomy can be used for select patients. Because of late failures patients who undergo either of these procedures should receive long-term followup.",
keywords = "laparoscopy, robotics, ureteral obstruction",
author = "Yanke, {Brent V.} and Lallas, {Costas D.} and Christopher Pagnani and McGinnis, {David E.} and Bagley, {Demetrius H.}",
year = "2008",
month = "10",
doi = "10.1016/j.juro.2008.06.020",
language = "English (US)",
volume = "180",
pages = "1397--1402",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "4",

}

TY - JOUR

T1 - The Minimally Invasive Treatment of Ureteropelvic Junction Obstruction

T2 - A Review of Our Experience During the Last Decade

AU - Yanke, Brent V.

AU - Lallas, Costas D.

AU - Pagnani, Christopher

AU - McGinnis, David E.

AU - Bagley, Demetrius H.

PY - 2008/10

Y1 - 2008/10

N2 - Purpose: The minimally invasive treatment of ureteropelvic junction obstruction has evolved during the last decade from endoscopic to laparoscopic and robotic. We review our 10-year experience with ureteropelvic junction obstruction, and report on our experience and followup. Materials and Methods: We reviewed all patients treated during the last 10 years. There were 294 procedures performed with complete records on 273 patients including 128 retrograde endopyelotomies, 116 laparoscopic pyeloplasties and 29 robotic pyeloplasties. Technique for each procedure is reviewed. Statistical analysis was performed on all results. Variables evaluated were gender, age (younger than 41 vs 41 years or older), side (right or left), presence of crossing vessels, presence of a high insertion, primary or secondary procedure and whether prior endopyelotomy or pyeloplasty had been performed. Results: Mean followup for endopyelotomy, laparoscopic pyeloplasty and robotic pyeloplasty was 20, 20 and 19 months, respectively, with success rates of 60.2%, 88.8% and 100%, respectively. On univariable analysis only the presence of crossing vessels or a high insertion was significant for laparoscopic pyeloplasty. On multivariable analysis age was significant for endopyelotomy and the presence of crossing vessels was significant for pyeloplasty. On Kaplan-Meier analysis failures were noted to occur after 5 years in both groups. Conclusions: Laparoscopic pyeloplasty and robotic pyeloplasty are superior minimally invasive treatments for ureteropelvic junction obstruction. However, endopyelotomy can be used for select patients. Because of late failures patients who undergo either of these procedures should receive long-term followup.

AB - Purpose: The minimally invasive treatment of ureteropelvic junction obstruction has evolved during the last decade from endoscopic to laparoscopic and robotic. We review our 10-year experience with ureteropelvic junction obstruction, and report on our experience and followup. Materials and Methods: We reviewed all patients treated during the last 10 years. There were 294 procedures performed with complete records on 273 patients including 128 retrograde endopyelotomies, 116 laparoscopic pyeloplasties and 29 robotic pyeloplasties. Technique for each procedure is reviewed. Statistical analysis was performed on all results. Variables evaluated were gender, age (younger than 41 vs 41 years or older), side (right or left), presence of crossing vessels, presence of a high insertion, primary or secondary procedure and whether prior endopyelotomy or pyeloplasty had been performed. Results: Mean followup for endopyelotomy, laparoscopic pyeloplasty and robotic pyeloplasty was 20, 20 and 19 months, respectively, with success rates of 60.2%, 88.8% and 100%, respectively. On univariable analysis only the presence of crossing vessels or a high insertion was significant for laparoscopic pyeloplasty. On multivariable analysis age was significant for endopyelotomy and the presence of crossing vessels was significant for pyeloplasty. On Kaplan-Meier analysis failures were noted to occur after 5 years in both groups. Conclusions: Laparoscopic pyeloplasty and robotic pyeloplasty are superior minimally invasive treatments for ureteropelvic junction obstruction. However, endopyelotomy can be used for select patients. Because of late failures patients who undergo either of these procedures should receive long-term followup.

KW - laparoscopy

KW - robotics

KW - ureteral obstruction

UR - http://www.scopus.com/inward/record.url?scp=50949121683&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=50949121683&partnerID=8YFLogxK

U2 - 10.1016/j.juro.2008.06.020

DO - 10.1016/j.juro.2008.06.020

M3 - Article

C2 - 18707717

AN - SCOPUS:50949121683

VL - 180

SP - 1397

EP - 1402

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 4

ER -