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Robot yardımlı transperitoneal piyeloplasti sonuçları: Vaka serisi

Year 2019, Volume: 3 Issue: 12, 870 - 872, 03.12.2019

İbrahim Karabulut Ali Haydar Yılmaz Fatih Kürşat Yılmazel Fatih Özkaya

https://doi.org/10.28982/josam.638664

Abstract

Amaç: Üretero pelvik bileşke (ÜPB) darlıkları idrarın renal pelvisten üretere geçişini kısıtlayan ve gerekli durumlarda tedavi edilmezse kademeli olarak böbrek fonksiyonlarında kayıba yol açabilen bir durum olarak kabul edilir. ÜPB darlıklarını dıştan başı yada iç tıkanıklığa bağlı olabilir. Semptomatik ÜPB darlıkları tedavi edilmelidir. Biz bu çalışmamızda kliniğimizde robot yardımlı piyeloplasti (RYP) yaptığımız hastaların sonuçlarını sunmayı amaçladık.

Yöntemler: Kliniğimizde Ocak 2017 - 2019 tarihleri arasında RYP yaptığımız 15 hastanın verileri incelendi. Üretero pelvik bileşke darlığı (UPBD) tanısı, intravenöz piyelografi (IVP) ve diürez renografisi (DTPA) ile hasta muayenesi veya olası kontrolleri takiben yapıldı. Da Vinci XI 4 kollu robotik sistem kullanan tüm hastalara dismembred piyeloplasti yapıldı. Sonuçlar retrospektif olarak değerlendirildi.

Bulgular: Hastaların yaş ortalaması 41,3 (8,2) idi. Cinsiyet dağılımı 7 erkek, 8 kadındı. Tüm işlemler birincil olgularda yapıldı. Hastaların 6' sında intrinsik obstrüksiyon, 9' unda dıştan dammar basısına bağlı ekstrinsik obstrüksiyon vardı. Ortalama ameliyat süresi 155,3 (29,8) dakika idi. Ortalama anastomoz süresi 33,4 (8,1) dakika idi. İntraoperatif kanama miktarı 48 (10.2) cc olarak bulundu. Ortalama hastanede kalış süresi 3,6 (1,1) gündü. Hiçbir hastada açık cerrahi müdahale olmadı. Hiçbir hastada intraoperatif veya postoperatif komplikasyon gözlenmedi. Ortalama takip süresi 12,7 (5,4) aydı. Postoperatif IVP ve DTPA tüm hastaların düzeldiği tespit edildi.

Sonuç: Çalışmamızda tespit edildiği gibi, RYP UPBD tedavisinde başarılı cerrahi ve fonksiyonel sonuçları olan minimal bir invaziv yöntemdir.

Keywords

Robotik Cerrahi Üreteropelvik obstrüksiyon Piyeloplasti

References

  • 1. Tripp BM, Homsy YL. Neonatal hydronephrosis-the controversy and the management. Pediatr Nephrol. 1995;9:503-9.
  • 2. Nakada SY, Hsu THS. Management of Upper Urinary Tract Obstruction. editor-in-chief, Wein AJ; editors, Kavoussi LR, Partin AW, Novick AC, Peters CA. Campbell-Walsh Urology, 10th Edition. Philadelphia: W.B. Saunders Elsevier; 2012.p.1122-3.
  • 3. Poulakis V, Witzsch U, Schultheiss D, Rathert P, Becht E. History of ureteropelvic junction obstruction repair (pyeloplasty). From Trendelenburg (1886) to the present. Urologe A. 2004;43:1544-59.
  • 4. Özmerdiven G, Kaygısız O, Çiçek Ç, Günseren KÖ, Vuruşkan H. The effect of laparoscopy courses in laparoscopy practice after urology resident training: A questionnaire-based observational study. J Surg Med. 2019;3:725-8.
  • 5. Symons JS, Palit V, Bi yani CS, Cartledge JJ, Browning AJ, Joyce AD. Minimally invasive surgical options for ureteropelvic junction obstruction: a significant step in the right direction. Indian J Urol. 2009;25:27-33.
  • 6. Albqami N, Janetschek G. Laparoscopic pyeloplasty. Ann Urol.2006;40:363-7.
  • 7. Jarrett TW, Chan DY, Charambura TC, Fugita O, Kavoussi LR. Laparoscopic pyeloplasty: the first 100 cases. J Urol.2002;167:1253-56.
  • 8. Eden CG. Minimally invasive treatment of ureteropelvic junction obstruction: a critical analysis of results. Eur Urol. 2007;52:983-9.
  • 9. Schuessler WW, Grune MT, Tecuanhuey LV, Preminger GM. Laparoscopic dismembered pyeloplasty. J Urol. 1993;150:1795-9.
  • 10. Miyake H, Kawabata G, Gotoh A, Fujisawa M, Okada H, Arakawa S, et al. Comparison of surgical stress between laparoscopy and open surgery in the field of urology by measurement of humoral mediators. Int J Urol. 2002;9:329-33.
  • 11. Canes D, Berger A, Gettman MT, Desai MM. Minimally invasive approaches to ureteropelvic junction obstruction. Urol Clin North Am. 2008;35:425-39.
  • 12. Yu HY, Hevelone ND, Lipsitz SR, Kowalczyk KJ, Hu JC. Use, costs and comparative effectiveness of robotic assisted, laparoscopic and open urological surgery. J Urol. 2012;187:1392-8.
  • 13. Başataç C, Boylu U, Önol FF, Gümüş E. Comparison of surgical and functional outcomes of open, laparoscopic and robotic pyeloplasty for the treatment of ureteropelvic junction obstruction. Turkish Journal of Urology. 2014;40:24-30.
  • 14. Canda AE, Atmaca AF, Balbay MD. Robotic Pyeloplasty: Step by Step Surgical Technique. Adv Robot Autom. 2013;2:1-5.
  • 15. Gupta NP, Nayyar R, Hemal AK, Mukherjee S, Kumar R, Dogra PN. Outcome analysis of robotic pyeloplasty: a large single-centre experience. BJU Int. 2010;105:980-3.
  • 16. Patel V. Robot-asisted laparoscopic dismembered pyeloplasty. Urology. 2005;66:45-9.
  • 17. Lucas SM, Sundaram CP, Wolf JS Jr, Leveillee RJ, Bird VG, Aziz M, et al. Factors that impact the outcome of minimally invasive pyeloplasty: Results of the Multi institutional Laparoscopic and Robotic Pyleoplasty Collaborative Group. J Urol. 2012;187:522-7.
  • 18. Minnillo BJ, Cruz JA, Sayao RH, Passerotti CC, Houck CS, Meier PM. Longterm experience and outcomes of robotic assisted laparoscopic pyeloplasty in children and young adults. J Urol. 2011;185:1455-60.
  • 19. Thom MR, Haseebuddin M, Roytman TM, Benway BM, Bhayani SB, Figenshau RS. Robot-assisted pyeloplasty: outcomes for primary and secondary repairs, a single institution experience. Int Braz J Urol. 2012;38:77-83.
  • 20. Niver BE, Agalliu I, Bareket R, Mufarrij P, Shah O, Stifelman MD. Analysis of robotic-assisted laparoscopic pyleloplasty for primary versus secondary repair in 119 consecutive cases. Urology. 2012;79:689-94.
  • 21. Pohl HG, Rushton HG, Park JS, Belman AB, Majd M. Early diuresis renogram findings predict success following pyeloplasty. J Urol. 2001;165:2311-5.
  • 22. Ener K, Altınova S, Canda AE, Özcan MF, Asil E, et al. Outcomes of robot-assisted laparoscopic transperitoneal pyeloplasty procedures: a series of 18 patients.Turk J Urol. 2014;40(4):193-8.

Outcomes of robot-assisted transperitoneal pyeloplasty: Case series

Year 2019, Volume: 3 Issue: 12, 870 - 872, 03.12.2019

İbrahim Karabulut Ali Haydar Yılmaz Fatih Kürşat Yılmazel Fatih Özkaya

https://doi.org/10.28982/josam.638664

Abstract

Aim: Ureteral pelvic junction (UPJ) obstruction, which restricts the passage of urine from the pelvis to the ureter may cause progressive destruction of the kidney if left untreated. Causes of UPJ obstruction include various intrinsic and extrinsic factors. Symptomatic UPJ obstruction should be treated without delay. We herein aimed to present the results of robot-assisted pyeloplasty (RAP) that we performed in our clinic.

Methods: Data of 15 patients who underwent RAP between January 2017 and 2019 in our clinic were examined. The diagnosis of ureteropelvic junction obstruction (UPJO) was based on intravenous pyelography (IVP), and diuresis renography (DTPA) was performed during follow-up. Dismembered pyeloplasty was performed on all patients with the DaVinci XI 4-arm robotic system. The results were retrospectively evaluated. 

Results: The mean age of all patients was 41.3 (8.2) years. There were 7 males and 8 females. None of the cases had previously undergone pyeloplasty. While 6 of the patients had intrinsic obstruction, 9 had extrinsic obstruction associated with aberrant vascular compression. The mean operation time and duration of anastomosis were 155.3 (29.8) and 33.4 (8.1) minutes, respectively. The mean amount of intraoperative bleeding was 48 (10.2) ml. The mean hospital stay was found as 3.6 (1.1) days. There was no conversion to open surgery in any of the patients. None of the patients had intraoperative or postoperative complications. The mean follow-up time was 12.7 (5.4) months. Postoperative IVP and DTPA of all the patients were found to have improved.

Conclusion: RAP is a minimally invasive method with successful surgical and functional outcomes in the treatment of UPJO.

Keywords

Robotic Surgery Ureteropelvic obstruction Pyeloplasty

References

  • 1. Tripp BM, Homsy YL. Neonatal hydronephrosis-the controversy and the management. Pediatr Nephrol. 1995;9:503-9.
  • 2. Nakada SY, Hsu THS. Management of Upper Urinary Tract Obstruction. editor-in-chief, Wein AJ; editors, Kavoussi LR, Partin AW, Novick AC, Peters CA. Campbell-Walsh Urology, 10th Edition. Philadelphia: W.B. Saunders Elsevier; 2012.p.1122-3.
  • 3. Poulakis V, Witzsch U, Schultheiss D, Rathert P, Becht E. History of ureteropelvic junction obstruction repair (pyeloplasty). From Trendelenburg (1886) to the present. Urologe A. 2004;43:1544-59.
  • 4. Özmerdiven G, Kaygısız O, Çiçek Ç, Günseren KÖ, Vuruşkan H. The effect of laparoscopy courses in laparoscopy practice after urology resident training: A questionnaire-based observational study. J Surg Med. 2019;3:725-8.
  • 5. Symons JS, Palit V, Bi yani CS, Cartledge JJ, Browning AJ, Joyce AD. Minimally invasive surgical options for ureteropelvic junction obstruction: a significant step in the right direction. Indian J Urol. 2009;25:27-33.
  • 6. Albqami N, Janetschek G. Laparoscopic pyeloplasty. Ann Urol.2006;40:363-7.
  • 7. Jarrett TW, Chan DY, Charambura TC, Fugita O, Kavoussi LR. Laparoscopic pyeloplasty: the first 100 cases. J Urol.2002;167:1253-56.
  • 8. Eden CG. Minimally invasive treatment of ureteropelvic junction obstruction: a critical analysis of results. Eur Urol. 2007;52:983-9.
  • 9. Schuessler WW, Grune MT, Tecuanhuey LV, Preminger GM. Laparoscopic dismembered pyeloplasty. J Urol. 1993;150:1795-9.
  • 10. Miyake H, Kawabata G, Gotoh A, Fujisawa M, Okada H, Arakawa S, et al. Comparison of surgical stress between laparoscopy and open surgery in the field of urology by measurement of humoral mediators. Int J Urol. 2002;9:329-33.
  • 11. Canes D, Berger A, Gettman MT, Desai MM. Minimally invasive approaches to ureteropelvic junction obstruction. Urol Clin North Am. 2008;35:425-39.
  • 12. Yu HY, Hevelone ND, Lipsitz SR, Kowalczyk KJ, Hu JC. Use, costs and comparative effectiveness of robotic assisted, laparoscopic and open urological surgery. J Urol. 2012;187:1392-8.
  • 13. Başataç C, Boylu U, Önol FF, Gümüş E. Comparison of surgical and functional outcomes of open, laparoscopic and robotic pyeloplasty for the treatment of ureteropelvic junction obstruction. Turkish Journal of Urology. 2014;40:24-30.
  • 14. Canda AE, Atmaca AF, Balbay MD. Robotic Pyeloplasty: Step by Step Surgical Technique. Adv Robot Autom. 2013;2:1-5.
  • 15. Gupta NP, Nayyar R, Hemal AK, Mukherjee S, Kumar R, Dogra PN. Outcome analysis of robotic pyeloplasty: a large single-centre experience. BJU Int. 2010;105:980-3.
  • 16. Patel V. Robot-asisted laparoscopic dismembered pyeloplasty. Urology. 2005;66:45-9.
  • 17. Lucas SM, Sundaram CP, Wolf JS Jr, Leveillee RJ, Bird VG, Aziz M, et al. Factors that impact the outcome of minimally invasive pyeloplasty: Results of the Multi institutional Laparoscopic and Robotic Pyleoplasty Collaborative Group. J Urol. 2012;187:522-7.
  • 18. Minnillo BJ, Cruz JA, Sayao RH, Passerotti CC, Houck CS, Meier PM. Longterm experience and outcomes of robotic assisted laparoscopic pyeloplasty in children and young adults. J Urol. 2011;185:1455-60.
  • 19. Thom MR, Haseebuddin M, Roytman TM, Benway BM, Bhayani SB, Figenshau RS. Robot-assisted pyeloplasty: outcomes for primary and secondary repairs, a single institution experience. Int Braz J Urol. 2012;38:77-83.
  • 20. Niver BE, Agalliu I, Bareket R, Mufarrij P, Shah O, Stifelman MD. Analysis of robotic-assisted laparoscopic pyleloplasty for primary versus secondary repair in 119 consecutive cases. Urology. 2012;79:689-94.
  • 21. Pohl HG, Rushton HG, Park JS, Belman AB, Majd M. Early diuresis renogram findings predict success following pyeloplasty. J Urol. 2001;165:2311-5.
  • 22. Ener K, Altınova S, Canda AE, Özcan MF, Asil E, et al. Outcomes of robot-assisted laparoscopic transperitoneal pyeloplasty procedures: a series of 18 patients.Turk J Urol. 2014;40(4):193-8.
There are 22 citations in total.

Details

Primary Language English
Subjects Urology
Journal Section Research article
Authors

İbrahim Karabulut 0000-0001-6766-0191

Ali Haydar Yılmaz 0000-0001-5797-0655

Fatih Kürşat Yılmazel 0000-0001-8744-5317

Fatih Özkaya 0000-0002-7776-4231

Publication Date December 3, 2019
Published in Issue Year 2019 Volume: 3 Issue: 12

Cite

APA Karabulut, İ., Yılmaz, A. H., Yılmazel, F. K., Özkaya, F. (2019). Outcomes of robot-assisted transperitoneal pyeloplasty: Case series. Journal of Surgery and Medicine, 3(12), 870-872. https://doi.org/10.28982/josam.638664
AMA Karabulut İ, Yılmaz AH, Yılmazel FK, Özkaya F. Outcomes of robot-assisted transperitoneal pyeloplasty: Case series. J Surg Med. December 2019;3(12):870-872. doi:10.28982/josam.638664
Chicago Karabulut, İbrahim, Ali Haydar Yılmaz, Fatih Kürşat Yılmazel, and Fatih Özkaya. “Outcomes of Robot-Assisted Transperitoneal Pyeloplasty: Case Series”. Journal of Surgery and Medicine 3, no. 12 (December 2019): 870-72. https://doi.org/10.28982/josam.638664.
EndNote Karabulut İ, Yılmaz AH, Yılmazel FK, Özkaya F (December 1, 2019) Outcomes of robot-assisted transperitoneal pyeloplasty: Case series. Journal of Surgery and Medicine 3 12 870–872.
IEEE İ. Karabulut, A. H. Yılmaz, F. K. Yılmazel, and F. Özkaya, “Outcomes of robot-assisted transperitoneal pyeloplasty: Case series”, J Surg Med, vol. 3, no. 12, pp. 870–872, 2019, doi: 10.28982/josam.638664.
ISNAD Karabulut, İbrahim et al. “Outcomes of Robot-Assisted Transperitoneal Pyeloplasty: Case Series”. Journal of Surgery and Medicine 3/12 (December 2019), 870-872. https://doi.org/10.28982/josam.638664.
JAMA Karabulut İ, Yılmaz AH, Yılmazel FK, Özkaya F. Outcomes of robot-assisted transperitoneal pyeloplasty: Case series. J Surg Med. 2019;3:870–872.
MLA Karabulut, İbrahim et al. “Outcomes of Robot-Assisted Transperitoneal Pyeloplasty: Case Series”. Journal of Surgery and Medicine, vol. 3, no. 12, 2019, pp. 870-2, doi:10.28982/josam.638664.
Vancouver Karabulut İ, Yılmaz AH, Yılmazel FK, Özkaya F. Outcomes of robot-assisted transperitoneal pyeloplasty: Case series. J Surg Med. 2019;3(12):870-2.
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