Laparoscopic Ureterolysis Without Omentoplasty in the Management of the Uropathy Secondary to Idiopathic Retroperitoneal Fibrosi
CASE REPORT Laparoscopic Ureterolysis without Omentoplasty in the Management of the Uropathy Secondary to Idiopathic Retroperitoneal Fibrosis Miguel A Bergero1, Patricio A Garcia Marchiñena2, Guillermo Gueglio3, Carlos David4, Fernando Dipatto5, Alberto Jurado6 ABSTRACT Introduction: Obstructive uropathy (OU) secondary to idiopathic retroperitoneal fibrosis (IRF) is an infrequent disease, and the standard treatment has not been established. However, ureterolysis with ureteral intraperitonealization is an effective therapeutic alternative. We present the successful management of OU secondary to an IRF by laparoscopic ureterolysis without omentoplasty (LUWO). Materials and methods: A retrospective descriptive study of 5 patients with IRF treated with LUWO was performed. Results: The average age was 60.4 years. The average creatinine was 3.86 mg/dL. There were no intraoperative or major postoperative complications. In a follow-up period of 31.2 months, all patients are asymptomatic, with an average creatinine level of 1.52 without dialysis requirement. No patients required corticosteroid therapy after surgery. Conclusion: Laparoscopic ureterolysis without omentoplasty is a safe and feasible option to treat the OU caused by IRF that provides good results in the medium-term follow-up, as we describe it in our series of cases. Keywords: Hydronephrosis, Laparoscopy, Retroperitoneal fibrosis, Ureteral obstruction. World Journal of Laparoscopic Surgery (2019): 10.5005/jp-journals-10033-1377 INTRODUCTION 1,4,5Department of Urology, Sanatorio Privado San Geronimo, Santa Fe, Obstructive uropathy (OU) related to idiopathic retroperitoneal Argentina fibrosis (IRF) is a rare disease characterized by retroperitoneal 2,3,6Department of Urology, Hospital Italiano de Buenos Aires, Buenos fibrosis. The pathology has theorized to be an inflammatory Aires, Argentina response to oxidized low-density lipoproteins.1,2 Because IRF has Corresponding Author: Miguel A Bergero, Department of Urology, 3–5 a very low prevalence, no treatments have been standardized.
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