scholarly journals Risk Factors and Management Options for the Adult Failed Ureteropelvic Junction Obstruction Repair in the Era of Minimally Invasive and Robotic Approaches: A Comprehensive Literature Review

2020 ◽  
Vol 34 (11) ◽  
pp. 1112-1119 ◽  
Author(s):  
Alexander K. Chow ◽  
Bryan J. Rosenberg ◽  
Edward M. Capoccia ◽  
Edward E. Cherullo
2009 ◽  
Vol 25 (1) ◽  
pp. 27 ◽  
Author(s):  
ChandraShekhar Biyani ◽  
JonJ Cartledge ◽  
AnthonyJ Browning ◽  
AdrianD Joyce ◽  
StephanieJ Symons ◽  
...  

2021 ◽  
pp. 039156032110261
Author(s):  
Lorenzo Masieri ◽  
Simone Sforza ◽  
Alekseja Manera ◽  
Luca Lambertini ◽  
Alfonso Crisci ◽  
...  

Background: Ureteropelvic Junction Obstruction (UPJO) is the most common congenital ureteral anomaly. Nowadays, according to the increasing incidence of urolithiasis, 20% of children with UPJO presents urolithiasis. Open pyeloplasty was the standard treatment before the introduction of minimally invasive surgery (MIS). Nevertheless, only scattered experiences on MIS were previously described and universal agreement on the treatment of UPJO plus urolithiasis is still missing. Objective: The study aim was to describe our experience with a series of pediatric patients affected by UPJO and urolithiasis treated with robot-assisted pyeloplasty (RAP) and endoscopic removal of stones using a flexible cystoscope and a stones basket in a singular tertiary referral center. Material and methods: We retrospectively reviewed our data from pediatric patients affected by UPJO and urolithiasis undergoing RAP between April 2013 and December 2019. The analysis was conducted on seven patients. All procedures were performed by one expert robotic surgeon and one endoscopic surgeon skilled in the management of urolithiasis. Results: The mean age was 7 years (IQR 4–16). The median stone area was 77.7 mm two (IQR 50.2–148.4). Most of them (71.4%) presented preoperative symptoms. The median operative time was 110 min (IQR 104–125) with a console time of 90 (IQR 90–105). The median length of stay was 5 days (IQR 4–5). Median follow-up was 16 months (IQR 10–25). Conclusion: RAP with concomitant flexible ureteroscope is a safe and effective option for the simultaneous management of UPJO with urolithiasis with excellent outcomes in children.


2018 ◽  
Author(s):  
Julia Beth Finkelstein ◽  
Pasquale Casale

Ureteropelvic junction obstruction (UPJO) is a common urologic abnormality in children. The diagnosis is typically based on a combination of clinical symptoms, ultrasonographic findings of hydronephrosis without hydroureter, and sometimes diuretic renal scintigraphy. Acceptance of robotic technology is increasing among pediatric urologists, and robotic pyeloplasty is now commonly performed for children with UPJO, with success rates similar to open pyeloplasty and a more efficient learning curve than conventional laparoscopy. The Anderson-Hynes dismembered pyeloplasty is the standard approach for repair. When complex patient anatomy is encountered, alternative techniques can be used to tailor the procedure to the specific case. Overall, robotic pyeloplasty offers strong outcomes, low complication rates, and a minimal rate of conversion to open surgery. Although the initial cost of robotic technology may be high, human capital gain and indirect benefits from shortened hospitalizations, smaller incisions, and parental satisfaction may be valuable.  This review contains 10 figures, 5 tables and 42 references Key words: Pediatrics, Minimally invasive surgery, Robotics, Ureteropelvic junction obstruction, Pyeloplasty, Urology


2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Thomas Peter Fox ◽  
Charles Godavitarne

Background. One of the most serious gastrointestinal disorders occurring in neonates is necrotising enterocolitis (NEC). It is recognised as the most common intra-abdominal emergency and is the leading cause of short bowel syndrome. With extremely high mortality and morbidity, this enigmatic disease remains a challenge for neonatologists around the world as its definite aetiology has yet to be determined. As current medical knowledge stands, there is no single well-defined cause of NEC. Instead, there are nearly 20 risk factors that are proposed to increase the likelihood of developing NEC. Aims and Objectives. The aim of this project was to conduct a comprehensive literature review around the 20 or so well-documented and less well-documented risk factors for necrotising enterocolitis. Materials and Methods. Searches of the Medline, Embase, and Science direct databases were conducted using the words “necrotising enterocolitis + the risk factor in question” for example, “necrotising enterocolitis + dehydration.” Search results were ordered by relevance with bias given to more recent publications. Conclusion. This literature review has demonstrated the complexity of necrotising enterocolitis and emphasised the likely multifactorial aetiology. Further research is needed to investigate the extent to which each risk factor is implicated in necrotising enterocolitis.


Author(s):  
Gastón M. Astroza ◽  
Ghalib Jibara ◽  
Michael E. Lipkin ◽  
Glenn M. Preminger

The open approach for stone surgery is currently used infrequently in patients undergoing stone removal. Currently an associated anatomic abnormality, a failure of or a contraindication to minimally invasive therapy, or a large and complex stone are the infrequent indications for open surgery. For these indications, laparoscopic or robotic approaches have almost completely replaced open procedures in the hands of skilled laparoscopic surgeons. Pyelolithotomy was supplanted almost 20 years ago by the advent of percutaneous and shock wave technology. Currently, the only indications for this procedure are a failure of or contraindication to other techniques, or the presence of an associated abnormality such as ureteropelvic junction obstruction, which could then be managed simultaneously.


2019 ◽  
Vol 41 (2) ◽  
Author(s):  
Salvatore Fabio Chiarenza ◽  
Cosimo Bleve ◽  
Ciro Esposito ◽  
Maria Escolino ◽  
Fabio Beretta ◽  
...  

The hydronephrosis, characterized by the dilation of the renal pelvicalyceal system with possible functional damage to the renal parenchyma, is the most common congenital abnormality of the urinary system detected in utero through the prenatal ultrasound screening. (...)


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