Page 42 - World Journal of Laparoscopic Surgery

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)