Pieloplastie laparoscopica în regim de chirurgie de o zi: experienta initiala.

Introduction: Over the last decades there has been an ascending trend towards minimally invasive techniques for managing PUJO (pelvi-ureteric junction obstruction). The aim of the present retrospective study is to report the initial experience and to assess the feasibility and safety of day case laparoscopic pyeloplasty. Material and Methods: Data on all patients who underwent day case laparoscopic pyeloplasty from October 2006 to October 2008 was collected. The inclusive criterion for this study was patients with PUJO who were planned for day case laparoscopic pyeloplasty. All patients followed a standard pathway of care for day case laparoscopic procedure. The diagnosis of PUJO was confirmed by diuretic renography (furosemide technetium-99m mercaptoacetyltriglycine renal scan) in all cases. To assess the functional result of the pyeloplasty and to have an objective measurement the renal scan was repeated between three and six months postoperatively. The success rate of DS and readmission rate were collected and evaluated. Results: During the study period there were 15 patients with PUJO planned for day case transperitoneal laparoscopic pyeloplasty. Age ranges from 11 to 68 years old. American Society of Anaesthesiology (ASA) was three in one case and 1 and 2 for the other patients. The patient with an ASA of three failed to be discharged. Three patients had medical co-morbidities: cardiac or respiratory. Fourteen patients have been successfully discharged and one patient failed discharge. No patient needed reassessment after discharge. Conclusion: Although the numbers in our series are too small to draw final conclusions, we think that patients, physicians and also hospitals could benefit if in selected cases the laparoscopic pyeloplasty is done as day-case surgery, without compromising the safety of the patient. [ABSTRACT FROM AUTHOR]