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Laparoscopic Ureterolysis without Omentoplasty
                                                                  In our cases, the peri-colonic fat was interposed between the
                                                               ureter and the fibrosis (transposition of the ureter) without an
                                                               omental wrapping. 6 weeks after surgery, the ureteral stent was
                                                               removed.

                                                               results
                                                               Of the 5 patients analyzed, the average age was 60.4 years (55–67),
                                                               and 80% were female. Sixty percent of patients had back pain
                                                               and 40% oliguria. The average creatinine was 3.86 (1.2–8.6). All
                                                               patients had negative autoimmune disease markers and tumor
                                                               markers. The patient’s characteristics were described in Table 1.
                                                               All patients underwent ULIP without omentoplasty. There were
                                                               no intraoperative or postoperative complications major to
                                                               Clavien 2 (1 patient presented a wound infection that required
                                                               oral antibiotics). The average surgical time was 137 minutes
                                                               (97–215) with an average blood loss of 84 (10–110) mL, without
            Figs 4A to D: (A) Kidney; (B) Intraperitonealization of the ureter; (C)   requiring transfusions. The average time of hospitalized was
            Interposition of pericolonic fat with its fascia between the ureter and   51 hours (36–62), and all had mild pain that was controlled with
            the fibrosis; (D) Bladder                          non-steroidal analgesics.
            Table 1: Patient’s characteristics
            A/S   CR                Symptoms         BT        DI          CTh      PBS TTO     PA    Follow-up
            67* ♂ Left RN (2005)    Back pain,       Cr 8.6    CT: right RF, OU No  US  Right   IRF   2018: Ç
                                    oligoanuria (2013) Ç                                LUWI WO
                                                     ESR: 80   MRI: IDEM                              No symptoms
                                                     TM (−)    RS: OU                                 Cr 1.9
                                                     MAD (−)                                          RS: no OU
                                                                                                      No CTh
                                  Ç
            63* ♀ Cholecystectomy 2014: ,  Back pain (2016) Ç  Cr 3.7  CT: left RF, OU   Prednisone US  Left LUWI  IRF  2018: Ç
                  right IRF + OU OUWI                          MRI: IDEM                WO
                                                     ESR: 95   RS: OU      Intolerance                No symptoms
                                                     TM (−)    PET: PAM                               Cr 2.1
                                                     MAD (−)                                          RS, no OU
                                                                                                      No CTh
            52* ♀ AH                Back pain (2015) Ç  Cr 1.3  CT: right RF,   Prednisone US  Left LUWI  IRF IG4  2018: Ç
                                                               OU. MRI: IDEM            WO      (+)
                                                     ESR: 78   RS: OU      Tamoxifen                  No symptoms
                                                     TM (−)    PET: PAM                               Cr 1
                                                     MAD (−)                                          RS: no OU
                                                                                                      No CTh
            65* ♀ Cholecystectomy   Oligoanuria (2016) Ç  Cr 4.5  CT: bilateral RF,  Prednisone US  Left LUWI  IRF  2018: Ç
                                                               OU. MRI: IDEM            WO
                                                     ESR: 87   RS: OU      Intolerance                No symptoms
                                                     TM (−)    RK no RP                               Cr 1.7
                                                     MAD (−)                                          RS, no OU
                                                                                                      No CTh
            55* ♀ No                Asthenia weight loss  Cr 1.2  CT: right RF   Prednisone US  Left LUWI  IRF  2018: Ç
                                    (2017) Ç                   OU. MRI: IDEM            WO
                                                     ESR: 90   RS: OU      Tamoxifen                  No symptoms
                                                     TM (−)                                           Cr 0.9
                                                     MAD (−)                                          RS, no OU
                                                                                                      No CTh
            A/S, age and sex of the patients; CR, clinical record; BT, blood test; DI, diagnostic image; *, age; ♂, male; ♀, woman; RN, radical nephrectomy; AH, arterial hyper-
            tension; Ç, year; Cr, creatinine (mg/dL); ESR, erythrosedimentation rate (mm/hour); TM, tumor markers; MAD, markers of autoimmune disease; CT, computed
            tomography; MRI, magnetic resonance imaging; RS, renal scintigraphy; PET, positron emission tomography; OU, obstructive uropathy; RK, right kidney; LK, left
            kidney; RF, retroperitoneal fibrosis; IRF, idiopathic retroperitoneal fibrosis; LUWI, laparoscopic ureterolysis with intraperitonealization; LUWI WO, laparoscopic ure-
            terolysis with intraperitonealization without omentoplasty; OUWI, open ureterolysis with intraperitonealization; US, ureteral stent; CTh, corticosteroids therapy;
            PBS, procedure before surgery; RE, renal ectasia; TTO, treatment; PA, pathological anatomy; RP, renal parenchyma

            128   World Journal of Laparoscopic Surgery, Volume 12 Issue 3 (September–December 2019)
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