Complications of laparoscopic pyeloplasty on Clavien classification

Guliev B.G., Aliev R.V.

The aim of this study was to evaluate the complications of the laparoscopic pyeloplasty (LP) using the classification of the Clzvien. 

We have performed the retrospective analysis of medical records of 105 patients, who were operated on using the LP. For further comparison we have divided all patients into three groups with 35 patients in each group, considering the sex and age of the patients, severity of hydronephrosis, presence of the lower pole vessels and collecting system stones. 

The efficacy of the operation was 91.4%. Clavien Grade I complications were observed in 14 patients (13.3%), including hematuria without need for blood transfusion, dysuria, urine leakage through the drainage with spontaneous cessation. Clavien Grade II complications were evident in 11 patients (10.4%): fever in 8 patients (7.6%), hematuria with need for hemotransfusion in 3 patients (2.8%). Six patients (5.7%) presented with Clavien Grade IIIa complications due to stent obstruction leading to urine leakage and hydroneprhosis. In two cases stent was successfully changed, in 4 patients percutaneous nephrostomy was carried out. Grade IIIb complication was noticed in one patient, which required the laparoscopic revision of pyeloureteral anastomosis and placement of the additional sutures. 

The analysis of the complications of the LP shows that serious complications of the procedure (IIIa and higher) are only few. Severity of hydronephrosis, presence of the lower pole vessels and collecting system stones significantly influence the complication rate. 

Authors declare lack of the possible conflicts of interests. 

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pyeloureteral segment, stricture, hydronephrosis, pyeloplasty, laparoscopy, complications, Clavien classification