|
|
|
| Retroperitoneal laparoscopic non-dismembered pyeloplasty for uretero-pelvic junction obstruction due to crossing vessels: A matched-paired analysis and review of literature |
Jens Rassweilera*( ),Jan Kleinb,Ali Serdar Goezena
|
a Department of Urology and Pediatric Urology, SLK Kliniken Heilbronn, University of Heidelberg, Heibronn, Germany
b Department of Urology, Medical School Ulm, University of Ulm, Ulm, Germany |
|
|
|
|
Abstract Objective: To compare laparoscopic Anderson-Hynes pyeloplasty (LAHP) and retroperitoneal laparoscopic YV-pyeloplasty (LRYVP) in ureteropelvic junction obstruction (UPJ) in presence of a crossing vessels (CV). Methods: Our database showed 380 UPJO-cases,who underwent laparoscopic retroperitoneal surgery during the last 2 decades including 206 non-dismembered LRYVP, 157 dismembered pyeloplasties LAHP, and 17 cases of laparoscopic ureterolysis. Among them 198 cases were suitable for a matched-pair (2:1) analysis comparing laparoscopic retroperitoneal non-dismembered LRYVP (Group 1, n = 131) and dismembered LAHP (Group 2, n = 67) in presence of a crossing vessel. Patients were matched according to age, gender, kidney functions, and obstruction grade. Complications were graded according to modified Clavien-classification. Results: Comparative data were similar between both groups (LRYVP vs. LAHP) including mean operating time (112 min vs. 114 min), complication rates (4.2% vs. 7.3%) mainly Grade 1-2 according to Clavien classification, and success rates (90% vs. 89%). These results reflected in the reviewed literature indicate that LRYVP provides the advantage of minimal dissection in case of CV with similar outcome. However, redundant pelvis and anteriorly crossing vessels still require a dismembered pyeloplasty LAHP. Conclusion: LRYVP has achieved similar results compared with the previous golden standard of open surgery, especially in case of crossing vessels apart from presence of a redundant pelvis or anteriorly crossing vessel. This can be further improved when using the small access retroperitoneoscopic technique respectively mini-laparoscopy.
|
|
Received: 09 March 2017
Published: 23 July 2018
|
|
Corresponding Authors:
Rassweiler Jens
E-mail: jens.rassweiler@slk-kliniken.de
|
|
|
| Author (year) | n | Age (year) (range) | Access | Primary
UPJ-ste- nosis (%) | Crossing vessels (%) | Mean OR-time (min) | Success /excellent rate (%) | Complication rate (%) | | Nguyen (1989) [3] | 68 | 2
(<1-28) | Flank | 100 | n.a. | n.a. | 93.4/n.a. | 17.1 | | MacNeily et al. (1993) [4] | 75 | 1
(<1-19) | Flank | 100 | n.a. | n.a. | 90.7/85.0 | 17.0 | | Woo and Farnsworth (1996) [5] | 63 | <1 | Flank | 100 | n.a. | n.a. | 94.0/n.a. | 11.0 | | Wiener and Roth (1998) [8] | 17 | 3 | Flank | 100 | n.a. | 110 | 94.0/n.a. | 23 | | Wiener and Roth (1998) [6]? | 16 | 4 | Lumbar | 100 | n.a. | 107 | 94.0/n.a. | 12.5 | | McAleer and Kaplan (1999) [7] | 79 | 1
(<1-18) | Flank | 100 | n.a. | n.a. | 90.0/71.0 | n.a. | | Bauer et al. (1999) [8] | 35 | n.a.
(adults) | Flank | 100 | 38 | 163 | 94.0/82.9 | 11.0 | | Sanchez Zalabardo (2000) [9] | 62 | 29
(<1-68) | Flank | n.a. | n.a. | n.a. | 90.3/n.a. | 29.0 | | Austin et al. (2000) [10] | 137 | 2
(<1-10) | Flank | 100 | n.a. | n.a. | 99.0/91.0 | 2.9 | | O'Reilly (2001) [11] | 28 | 39
(12-72) | Flank | 100 | n.a. | n.a. | 82.2/67.9 | 17.9 | | Klingler (2003) [12] | 15 | 41
(13-69) | Flank | 100 | 47 | n.a. | 93.3/n.a. | 40.0 | | Total | 595 | <1-41
(<1-72) | | | 38-47 | 107-163 | 90-99/68-91 | 2.9-40.0 |
|
|
|
| Author (year) | n | Age (range) | Access | Primary UPJ-ste- nosis (%) | Crossing vessels (%) | Mean OR-time (min) | Success rate (%)/excellent | Complication rate (%) | | Tan (1999) [19] | 18 | 2
(1-15) | Trans | 89 | n.a | 90
(70-160) | 87/n.a | 11 | | Janetschek et al. (2000) [21] | 67 | 36
(11-77) | Trans/
retro | 100 | 79 | 119
(90-210) | 98/n.a. | 3 | | Soulie et al. (2001) [23] | 55 | 35
(17-72) | Retro | 98 | 41.9 | 185
(100-260) | 90.1/87.2 | 12.7 | | Eden et al. (2001) [24] | 50 | 36 | Retro | 92 | 42 | 164
(100-210) | 98/84.0. | 4 | | Jarrett et al. (2002) [25] | 100 | 37
(12-85) | Trans | 83 | 57 | 252a
(120-480) | 98/n.a. | 13 | | Türk et al. (2002) [26] | 49 | 34
(6-65) | Trans | 100 | 57.1 | 165
(90-240) | 97.7/81.6 | 2 | | Klingler et al. (2003) [12] | 40 | 36
(15-57) | Trans | 88 | 82.5 | n.a. | 92.5/87.5 | 17.5 | | Sundaram et al. (2003) [27] | 36 | 34
(16-60) | Trans | n.a. | 87 | 372+(162-600) | 94/83 | 25+ | | Rassweiler et al. (2007) [28] | 52 | 37
(6-75) | Retro | 78 | 76 | 137
(60-260) | 94/88 | 6 | Present series
2018 | 380 | 34
(0.5-92) | Retro | 92 | 58 | 113
(29-240) | 92/88 | 5.5 | | Total | 847 | 34-37
(0.5-92) | | 83-100 | 42-87 | 119-185 | 90-98/82-87 | 2-17.5 |
|
|
|
|
|
Algorhythm of modern diagnosis of uretero-pelvic junction (UPJ)-obstruction primarily based on findings of colour-duplex ultrasound (CDUS), and magnetic resonance urography respectively isotope nephrogram (ING) with split function and a furosemide wash-out) to evaluate functional relevance of the stenosis. Retrograde pyelography (RPG) is used prior to the procedure. AHP, Anderson-Hynes pyeloplasty; LEP, laserendopyelotomy; YVP, YV-pyeloplasty; CT, computed tomography.
|
|
|
Trocar arrangement for right laparoscopic retroperitoneal pyeloplasty: Optic port (PⅠ) between M. abdominisexternus ① and M. lattisimusdorsi ② at the lumbar trigone ③. Five or ten micrometer port for right hand (PⅡ), 3/5 mm ④ rectus muscle port for left hand (PⅢ). Optional 3/5 mm port (PⅣ) medially.
|
|
|
Access for small-access retroperitoneoscopic technique (SMART)-pyeloplasty (A) Self-made balloon-trocar using finger of latex-free glove fixed to 5 mm-trocar; (B) Balloon dilatation using air-insufflation via 5 mm-trocar und endoscopic control; (C) Placement of two 3 mm-trocars under endoscopic control; (D) Use of ETHOS-platform during small access retroperitoneoscopic technique SMART-pyeloplasty providing armrests and a support for the chest of the surgeon.
|
|
|
Laparoscopic retroperitoneal pyeloplasty using YV-plasty (LRYVP) in case of anteriorly crossing vessel (A) Schematic drawing of left anteriorly crossing vessel; (B) Schematic drawing of principle of YV-plasty; (C) Schematic drawing of anatomical situation after YV-plasty; (D) Final endoscopic view after anastomosis.
|
|
|
Laparoscopic retroperitoneal pyeloplasty—technical details of non-dismembered pyeloplasty (SMART-technique). (A) Incision of renal pelvis and spatulation of ureter in a Y-form. The incised stenotic UPJ is included in the pelvis; (B) Initiation of pyeloplasty in a continuous fashion (Vicryl, 4-0, RB1-needle) at the medial side of the pelvis and ureter; (C) Creation of neo-UPJ anastomosing the pelvic flap to the spatulated ureter; (D) Exposition of the medial part of the anastomosis in V-form. SMART, small access retroperitoneoscopic technique; UPJ, uretero-pelvic junction.
|
|
|
Laparoscopic retroperitoneal pyeloplasty—Dismembered pyeloplasty (LAHP) in case of posteriorly crossing vessel. (A) Schematic drawing of posteriorly crossing vessel; (B) Resection of stenotic part, reduction of pyleon and spatulation of ureter; (C) Schematic drawing of anatomical situation after dismembered pyeloplasty. (D) Laparoscopic picture of the reconstructed ureteropelvic junction after dismembered pyeloplasty.
|
| Parameters | Non-dismembered (LRYVP) | Dismembered pyeloplasty (LAHP) | p-Value | | n | 131 | 67 | | | Mean age (year) | 34.6 ± 2 | 32.6 ± 1.6 | 0.5 | | Gender | | | 0.3 | | Female (%) | 74 (58) | 33 (49) | | | Male (%) | 57 (42) | 34 (51) | | | Preoperative pain | 116 (89) | 57 (85) | 0.3 | | Preoperative obstruction grade n, (%) | | | 0.3 | | Grade 1 | 3 (3) | 2 (3) | | | Grade 2 | 75 (57) | 29 (43) | | | Grade 3 | 53 (40) | 36 (54) | |
|
|
|
| Parameters | Non-dismembered (LRYVP) | Dismembered pyeloplasty (LAHP) | p-Value | | n | 131 | 67 | | | Mean preoperative kidney functions | 35.1 ± 1.1 | 35.9 ± 1.0 | 0.5 | | Mean postoperative kidney functions | 36.3 ± 1.0 | 37.7 ± 1.0 | 0.2 | | Mean operation time (min) | 112 ± 33.4 | 114 ± 45.1 | 0.3 | | Complications according to Clavien Classification n (%) | | | 0.2 | | Grade 1 | 1 (0.8) | 3 (4.4) | | | Grade 2 | 2 (1.4) | 2 (2.9) | | | Grade 3a | 2 (1.4) | 0 | | | Grade 3b | 1 (0.8) | 0 | | | Grade 4 | - | - | | | Grade 5 | - | - | | | Success rate, n (%) | 118 (90) | 60 (89) | 0.6 |
|
|
|
|
|
Cosmetic aspect of small access retroperitoneoscopic technique (SMART)-pyeloplasty vs. retroperitoneoscopy. (A) Minimal scars 3 months after SMART; (B) Significantly larger scars after conventional retroperitoneoscopy.
|
| [1] |
R.H. Whitaker . Clinical assessment of pelvic and ureteral function.Urology, 12(1978), pp. 146-150
doi: 10.1016/0090-4295(78)90324-2
pmid: 695143
|
| [2] |
J.A. Jacobs, B.W. Berger, S.M. Goldman, M.A. Robbins, J.D. Young Jr . Ureteropelvic obstruction in adults with previously normal pyelograms: a report of 5 cases.J Urol, 121(1979), pp. 242-244
doi: 10.1016/S0022-5347(17)56735-X
pmid: 423343
|
| [3] |
D.H. Nguyen, H. Aliabadi, C.J. Ercole, R. Gonzalez . Nonintubated Anderson-Hynes repair of ureteropelvic junction obstruction in 60 patients.J Urol, 142(1989), pp. 704-706
doi: 10.1111/j.1464-410X.1989.tb06031.x
pmid: 2671411
|
| [4] |
A.E. MacNeily, M. Maizels, E. Kaplan, C.F. Firlit, J.J. Conway . Does early pyeloplasty really avert loss of renal function? A retrospective review.J Urol, 150(1993), pp. 769-773
doi: 10.1089/end.1993.7.337
pmid: 8326643
|
| [5] |
H.H. Woo, R.H. Farnsworth . Dismembered pyeloplasty in infants under the age of 12 months.Br J Urol, 77(1996), pp. 449-451
doi: 10.1046/j.1464-410X.1996.89723.x
pmid: 8814855
|
| [6] |
J.S. Wiener, D.R. Roth . Outcome based comparison of surgical approaches for pediatricpyeloplasty: dorsal lumbar versus flank incision.J Urol, 159(1998), pp. 2116-2119
doi: 10.1016/S0022-5347(01)61811-1
pmid: 9598553
|
| [7] |
I.M. McAleer, G.W. Kaplan . Renal function before and after pyeloplasty: does it improve?J Urol, 162(1999), pp. 1041-1044
doi: 10.1016/j.ultrasmedbio.2004.02.009
pmid: 10458428
|
| [8] |
J.J. Bauer, J.T. Bishoff, R.G. Moore, R.N. Chen, A.J. Iverson, L.R. Kavoussi . Laparoscopic versus open pyeloplasty: assessment of objective and subjective outcome.J Urol, 162(1999), pp. 692-695
doi: 10.1097/00005392-199909010-00016
pmid: 10458344
|
| [9] |
Zalabardo D. Sanchez, Ferrandis J. Lopez, Garcia-Tapia J. Arocena, G. Perez, Alonso F. Diez-Caballero, Costa D. Rosell , et al.Pyeloureteral junction stenosis: our experience and review of the literature.Actas Urol Esp, 24(2000), pp. 367-374
doi: 10.1016/S0210-4806(00)72465-X
|
| [10] |
P.F. Austin, M.P. Cain, R.C. Rink . Nephrostomy tube drainage with pyeloplasty: it is necessarily a bad choice?J Urol, 163(2000), pp. 1528-1530
doi: 10.1016/S0022-5347(05)67671-9
pmid: 10751882
|
| [11] |
P.H. O'Reilly, P.J. Brooman, S. Mak, M. Jones, C. Pickup, C. Atkinson , et al.The long-term results of Anderson-Hynes pyeloplasty.BJU Int, 87(2001), pp. 287-289
doi: 10.1046/j.1464-410x.2001.00108.x
pmid: 11251517
|
| [12] |
H.C. Klingler, M. Remzi, G. Janetschek, C. Kratzik, M. Marberger . Comparison of open versus laparoscopic pyeloplasty techniques in treatment of uretero-pelvic junction obstruction.Eur Urol, 44(2003), pp. 340-345
doi: 10.1016/S0302-2838(03)00297-5
pmid: 15879812
|
| [13] |
J.W.A. Ramsey, R.A. Miller, M.J. Kellet, H.N. Blackford, J.E.A. Wickham, H.M. Whitfield . Percutaneous pyelolysis: indications, complications and results.Br J Urol, 56(1984), pp. 586-588
doi: 10.1111/j.1464-410X.1984.tb06122.x
pmid: 6534471
|
| [14] |
J.A. Motola, G.H. Badlani, A.D. Smith . Results of 212 consecutive endopyelotomies:an 8-year followup.J Urol, 149(1993), pp. 453-456
doi: 10.1111/j.1464-410X.1993.tb15969.x
pmid: 8437245
|
| [15] |
P.J. Van Cangh, J.F. Wilmart, R.J. Opsomer, A. Abi-Aad, F.X. Wese, F. Lorge . Long-term results and late recurrence after endopyleotomy: a critical analysis of prognostic factors.J Urol, 151(1994), pp. 934-937
doi: 10.1089/end.1994.8.165
pmid: 8126829
|
| [16] |
M. Gupta, O.L. Tuncay, A.D. Smith . Open surgical exploration after failed endopyelotomy: a 12-year perspective.J Urol, 157(1997), pp. 1613-1616
doi: 10.1016/S0022-5347(01)64808-0
pmid: 9112488
|
| [17] |
C. Renner, T. Frede, O. Seemann, J. Rassweiler . Laserendopyelotomy: minimallly invasive therapy of ureteropelvic junction stenosis.J Endourol, 12(1998), pp. 537-544
doi: 10.1089/end.1998.12.537
pmid: 9895259
|
| [18] |
C.S. Biyani, P.A. Cornford, C.S. Powell . Ureteroscopicendopyelotomy with the Holmium:YAG laser, mid-term results.Eur Urol, 38(2000), pp. 139-143
doi: 10.1159/000020270
pmid: 10895003
|
| [19] |
H.L. Tan . Laparoscopic Anderson-Hynes dismembered pyeloplasty in children.J Urol, 162(1999), pp. 1045-1048
doi: 10.1016/S0022-5347(01)68060-1
|
| [20] |
G. Janetschek, R. Peschel, S. Altarac, G. Bartsch . Laparoscopic and retroperitoneoscopic repair of ureteropelvic junction obstruction.Urology, 47(1996), pp. 311-316
doi: 10.1016/S0090-4295(99)80444-0
pmid: 8633393409300143002282013
|
| [21] |
G. Janetschek, R. Peschel, G. Bartsch . Laparoscopic fenger plasty.J Endourol, 14(2000), pp. 889-893
doi: 10.1089/end.2000.14.889
|
| [22] |
J.J. Rassweiler, C. Renner, O. Seemann, T. Frede . Retroperitoneoscopic pyeloplasty. A.K. Hemal ( Ed.), Laparoscopic urologic surgery. Retroperitoneal and transperitoneal, Churchill Livingston, New Delhi(2000), pp. 201-212
|
| [23] |
M. Soulie, L. Salomon, J.J. Patard, P. Mouly, A. Manunta, P. Antiphon , et al.Extraperitoneal laparoscopic pyeloplasty: a multicenter study of 55 procedures.J Urol, 166(2001), pp. 48-50
doi: 10.1016/S0022-5347(05)66073-9
pmid: 11435820
|
| [24] |
C.G. Eden, D. Cahill, J.D. Allen . Laparoscopic dismembered pyeloplasty: 50 consecutive cases.BJU Int, 88(2001), pp. 526-531
doi: 10.1046/j.1464-4096.2001.02382.x
pmid: 11678744
|
| [25] |
T.W. Jarrett, D.Y. Chan, T.C. Chambura, O. Fugita, L.R. Kavoussi . Laparoscopic pyeloplasty: the first 100 cases.J Urol, 167(2002), pp. 1253-1256
doi: 10.1016/S0022-5347(05)65276-7
pmid: 11832708
|
| [26] |
I.A. Türk, J.W. Davis, B. Winkelmann, S. Deger, F. Richter, M.D. Fabrizio , et al.Laparoscopic dismembered pyeloplasty-the method of choice in the presence of an enlarged renal pelvis and crossing vessels.Eur Urol, 42(2002), pp. 268-275
doi: 10.1016/S0302-2838(02)00315-9
pmid: 12234512
|
| [27] |
C.P. Sundaram, R.L. Grubb, J. Rehman, Y. Yan, C. Chen, J. Landman , et al.Laparoscopic pyeloplasty for secondary ureteropelvic junction obstruction.J Urol, 169(2003), pp. 2037-2040
doi: 10.1097/01.ju.0000067180.78134.da
pmid: 12771713
|
| [28] |
J.J. Rassweiler, S. Subotic, M. Feist-Schwenk, M. Sugiono, M. Schulze, D. Teber , et al.Minimally invasive treatment of ureteropelvic junction obstruction: long-term experience with an algorithm for laser endopyelotomy and laparoscopic retroperitoneal pyeloplasty.J Urol, 177(2007), pp. 1000-1005
doi: 10.1016/j.juro.2006.10.049
pmid: 17296396
|
| [29] |
S. Subotic, H. Weiss, C.A. Rentsch, J. Rassweiler, A. Bachmann, D. Teber . Dismembered and non-dismembered retroperitoneoscopicpyeloplasty for treatment of ureteropelvic junction obstruction in children.World J Urol, 31(2013), pp. 689-695
doi: 10.1007/s00345-012-0887-0
pmid: 22618575
|
| [30] |
G. Pini, A.S. Goezen, M. Schulze, M. Hruza, J. Klein, J.J. Rassweiler . Small-incision access retroperitoneoscopic technique (SMART) pyeloplasty in adult patients: comparison of cosmetic and post-operative pain outcomes in a matched-pair analysis with standard retroperitoneoscopy: preliminary report.World J Urol, 30(2012), pp. 605-611
doi: 10.1007/s00345-011-0740-x
|
| [31] |
M. Al Nasser, G. Pini, A.S. G?zen, O.M. Elashry, Y. Akin, J. Klein , et al.Comparative study for evaluating the cosmetic outcome of small-incision access retroperitoneoscopic technique (SMART) with standard retroperitoneoscopy using the Observer Scar Assessment Scale: are small incisions a big deal?J Endourol, 28(2014), pp. 1409-1413
doi: 10.1089/end.2014.0142
pmid: 25230126
|
| [32] |
C. Fiori, R. Bertolo, M. Manfredi, F. Mele, D. Amparore, G. Caltaneo , et al.Robot-assisted laparoendoscopic single-site versus mini-laparoscopic pyeloplasty: a comparison of perioperative, functional and cosmetic results.Minerva Urol Nefrol, 69(2017), pp. 604-612
doi: 10.23736/S0393-2249.17.02833-8
pmid: 28429925
|
| [33] |
L.S. Palmer, M. Maizels, P.C. Cartwright, S. Fernbach, J.J. Conway . Surgery versus observation for managing obstructive Grade 3 to 4 unilateral hydronephrosis: a report from the Society for Fetal Urology.J Urol, 159(1998), pp. 222-228
doi: 10.1097/00042307-199807000-00046
pmid: 9400485
|
| [34] |
A. Grignon, D. Filiastrault, Y. Homsy, P. Robitaille, R. Filion, H. Boutin , et al.Ureteropelvic junction stenosis: antenatal ultrasonographic diagnosis, postnatal investigation and follow-up.Radiology, 160(1986), pp. 649-651
doi: 10.1148/radiology.160.3.3526403
pmid: 3526403
|
| [35] |
J.H. Ross, R. Kay, N.S. Knippe, S.B. Streem . The absence of cossing vessels in association with ureteropelvic junction obstruction detected by prenatal ultrasonography.J Urol, 160(1998), pp. 973-975
doi: 10.1016/S0022-5347(01)62673-9
pmid: 9719256
|
| [36] |
G. Janetschek, F. Frauscher, G. Helweg . Incidence of crossing vessels at the ureteropelvic junction in healthy volunteers: assessment of color Doppler imaging.J Urol, 161(1999), pp. 324-327
doi: 10.1097/00005392-199904010-00342
|
| [37] |
A.A. Shokeir, A.P. Provoost, R.J. Nijman . Resistive index in obstructive uropathy.Br J Urol, 80(1997), pp. 195-200
doi: 10.1046/j.1464-410X.1997.00243.x
pmid: 9284187
|
| [38] |
H.L. Hopf, C.D. Bahler, C.P. Sundaram . Long-term outcomes of robot-assisted laparoscopic pyeloplastyfor ureteropelvic junction obstruction.Urology, 90(2016), pp. 106-110
doi: 10.1016/j.juro.2015.02.1441
pmid: 26801810
|
| [39] |
L.H. Braga, J. Pippi-Salle, A.J. Lorenzo, D. Bagli, A.E. Khoury, W.A. Farhat . Pediatric laparoscopic pyeloplasty in a referral center: lessons learned.J Endourol, 21(2007), pp. 738-742
doi: 10.1089/end.2006.0420
pmid: 17705762
|
| [40] |
J.H. Johnston, J.P. Evans, K.I. Glassberg, S.R. Shapiro . Pelvic hydronephrosis in children: a review of 219 personal cases.J Urol, 117(1977), pp. 97-101
doi: 10.1016/S0022-5347(17)58355-X
pmid: 830979
|
| [41] |
P.J. Van Cangh, S. Nesa, M. Galeon, B. Tombal, F.X. Wese, A.E. Dardenne , et al.Vessels around the ureteropelvic junction: significance and imaging by conventional radiology.J Endourol, 10(1996), pp. 111-119
doi: 10.1089/end.1996.10.111
pmid: 8728675
|
| [42] |
C. Pesce, P. Campobasso, L. Costa, F. Battaglino, L. Musi . Ureterovascular hydronephrosis in children: is pyleoplasty always necessary?Eur Urol, 36(1999), pp. 71-74
doi: 10.1159/000019930
pmid: 10364659
|
| [43] |
B. Chertin, A. Fridmans, I. Knizhnik, I. Hadas-Halperin, D. Hain, A. Farkas . Does early detection of ureteropelvic junction obstruction improve surgical outcome in terms of renal function.J Urol, 162(1999), pp. 1037-1040
doi: 10.1016/j.biopha.2004.05.004
pmid: 10458427
|
| [44] |
L. Kallai, I. Torda, M. Bely, G. Fischer, S. Mavrogenis, G. Nemec . Pyleloureteral junction stenosis and ureteral valve causing hydronephrosis.Scand J Urol Nephrol, 35(2001), pp. 245-247
doi: 10.1080/003655901750292051
pmid: 11487081
|
| [1] |
Farzaneh Sharifiaghdas,Mahboubeh Mirzaei,Azar Daneshpajooh,Shahin Abbaszadeh. Minimally invasive open dismembered pyeloplasty technique: Miniature incision, muscle-splitting dissection, and nopelvis reduction in children[J]. Asian Journal of Urology, 2019, 6(3): 290-293. |
| [2] |
Manickam Ramalingam,Nachimuthu Sivasankaran,Kallappan Senthil,G.Pai Mizar. Laparoscopic adenomectomy in BPH-Does it have a role today?[J]. Asian Journal of Urology, 2018, 5(1): 37-41. |
| [3] |
Jian Huang, Xinxiang Fan, Wen Dong. Current status of laparoscopic and robotassisted nerve-sparing radical cystectomy in male patients[J]. Asian Journal of Urology, 2016, 3(3): 150-155. |
| [4] |
Weil R. Lai, Benjamin R. Lee. Techniques to resect the distal ureter in robotic/laparoscopic nephroureterectomy[J]. Asian Journal of Urology, 2016, 3(3): 120-125. |
|
|
|
|
