Laparoscopic pyeloplasty for secondary XXXX : Long-term results.

@entity1 @entity3041 @entity190 @entity4145
OBJECTIVE: To evaluate the long-term results of laparoscopic pyeloplasty in @entity1 with secondary @entity4145 after failed primary interventions. METHODS: Between August 2000 and October 2012, transperitoneal dismembered laparoscopic pyeloplasty was carried out in 13 @entity1 with a surgical history of failed prior surgical interventions. Perioperative outcomes as well as long-term results were assessed. These outcomes were compared with those of the same procedure carried out for primary @entity4145 by a single surgeon during the same study period. RESULTS: Laparoscopic transperitoneal pyeloplasty was completed successfully in all cases without converting to open surgery or requiring blood transfusion. The preoperative symptoms in 12 of 13 @entity1 all disappeared soon after the operation. Asymptomatic severe @entity3041 found in a 2-year-old @entity1 reduced in size postoperatively. When comparing the primary with the secondary laparoscopic pyeloplasty carried out by the same surgeon, the mean operative time was longer (183 vs 241   min, P   =   0.002), estimated @entity190 was larger (33 vs 66   mL, P   =   0.03) and the complication rate was higher (8.8% vs 22.2%, P   =   0.01) in the secondary group. Success rates were 97.9% and 100% (P   =   0.41) at a mean follow up of 25.9 and 40.0   months (P   =   0.14) for the primary and secondary groups, respectively. CONCLUSIONS: Laparoscopic pyeloplasty is an excellent option for @entity1 who failed previous surgical management. This approach provides durable long-term outcomes comparable with those of primary treatment for @entity4145 .
