Purpose: We describe surgical techniques and experience with retroperitoneal laparoscopic pyeloureterostomy in five cases of retrocaval ureter (RU). We also report the laparoscopic approach reconstruction for RU from peer-reviewed publications.
Patients and methods: Five patients with RU underwent retroperitoneal laparoscopic pyeloureterostomy. Nuclear renography, intravenous urography (IVU), and ultrasonography follow-up was performed postoperatively. Science Citation Index searches were conducted to identify laparoscopic reconstruction for RU outcomes. Studies published after 1994 were included in the analysis.
Results: Operations were completed successfully and without complications in five patients. The mean operative time was 90.2 ± 34.4 minutes. The mean time needed to insert the Double-J stent and reanastomosis was 51.2 ± 11.4 minutes. Blood loss was minimal. Over a follow-up of 12 to 37 months, hydronephrosis was found to decrease substantially. There were 24 peer-reviewed studies covering a total of 62 patients suitable for inclusion in our final analysis. The most common method for reconstruction of the ureter was ureteroureterostomy, followed by pyeloureterostomy and pyelopyelotomy.
Conclusion: Retroperitoneal laparoscopy for RU is a safe and effective procedure that should be considered as a first-line treatment for patients with this anatomic anomaly.