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İlki FY, Bülbül E, Gultekin MH, Citgez S, Demirdag C, Ozden SB, Onal B. Comparison of laparoscopic and open ureterolysis for retroperitoneal fibrosis: Results from a tertiary referral center. J Endourol 2022; 36:1425-1430. [PMID: 35521656 DOI: 10.1089/end.2022.0135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To compare the surgical outcomes of open and laparoscopic ureterolysis procedures in patients requiring surgical treatment for ureteral obstruction caused by retroperitoneal fibrosis. MATERIALS This study was designed retrospectively. The clinical records of patients who underwent ureterolysis between January 2005 and April 2019 due to ureteral obstruction caused by retroperitoneal fibrosis 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. RESULTS Ureterolysis was performed in 13 patients and 23 renal units. Eleven of these patients were male and two were female. 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 successful in 21 of the renal units (91%) [11/12 (92%) in Group 1 vs 10/11 (91%) in Group 2]. No statistically significant difference was found between the groups in terms of the success and complication rates (p=1 and p=0.529, respectively). Postoperative hospitalization length and recovery time to return to normal preoperative activities were significantly shorter in Group 2 than Group 1 (p=0.011 and p=0.041, respectively). CONCLUSIONS 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.
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Affiliation(s)
- Fahri Yavuz İlki
- Istanbul University-Cerrahpasa, 532719, Urology, CERRAHPAŞA TIP FAKÜLTESİ, İSTANBUL, Istanbul, Turkey, 34000.,CERRAHPAŞA TIP FAKÜLTESİ;
| | - Emre Bülbül
- İstanbul Üniversitesi-Cerrahpaşa, 532719, Urology, İstanbul University of Cerrahpaşa-Cerrahpaşa school of medicine, Istanbul, Istanbul, Turkey, 34000;
| | | | - Sinharib Citgez
- Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Urology, İstanbul Üniversitesi-Cerrahpasa Tıp Fakültesi, Üroloji Anabilim Dalı, Fatih, İstanbul, İstanbul, Turkey, 34300.,United States;
| | - Cetin Demirdag
- Istanbul Universitesi Cerrahpasa Tip Fakultesi, 64298, Urology, Kocamustafapasa cd., 34098, Fatih, Istanbul, Turkey, 34098;
| | - Sami Berk Ozden
- Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Urology, Istanbul, Turkey;
| | - Bulent Onal
- Istanbul University- Cerrahpasa, Cerrahpasa School of Medicine, Department of Urology, Osmaniye Fildami Araligi Sok., Fildami Sitesi, A-Blok, No: 20, Istanbul, Turkey, 34144.,Turkey;
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