Transperitoneal laparoscopic uretero-ureter anastomosis

Objective To introduce the initial experience of transperitoneal laparoscopic uretero ureter anastomosis for ureteral obstruction. Methods This series included 9 cases (4 males and 5 females).Their mean age was 49 years (range,34-64 years).Five cases had obstruction on the left side and 4,on the right.Of the 9 cases,2 had upper segment ureterolithiasis with big polyps;1,retro venacaval ureter;1,upper segment ureter polyps;1,middle segment ureter tumor;1,middle segment ureter stricture;1,upper segment ureter stricture after open ureterolithotomy;1,middle segment ureterolithiasis with stricture;1,lower segment ureter ligation after hystero myomectomy.All the 9 cases underwent relief of ureter obstruction and uretero ureter anastomosis via laparoscope. Results The operations were all successful in 9 cases.The blood loss was 80-200 ml (mean,147 ml).No one needed blood transfusion.The operative time was 80-170 min (mean,116 men).Postoperative drain had no obvious leakage of urine.Double J tubes were removed 1 month after operation.The mean follow up was 14 months.IVU,BUS or RGU examinations showed that hydronephrosis was lessened and renal function was improved. No ureter stricture was found.One patient with ureter tumor was pathologically confirmed to suffer from ureter squamous carcinoma; the edge was negative.However,the patient developed recurrence 13 months after operation and then underwent renal fistulization again. Conclusions Laparoscopic uretero ureter anastomosis is an effective and minimally invasive method and can be used as an alternative approach to treatment of ureter obstruction.