Comparison of the efficacy and safety of retroperitoneal laparoscopic and open surgery for the correction of retrocaval ureter

OBJECTIVE The aim of this study was to compare the clinical efficacy and safety of retroperitoneal laparoscopic and open surgery for the correction of retrocaval ureter. PATIENTS AND METHODS Clinical data of 14 patients with retrocaval ureter were analyzed retrospectively. Among them, nine were treated by open surgical therapy and five by retroperitoneal laparoscopic surgery. The ureter was transpositioned to a normal anatomic position followed by laparoscopic intracorporeal uretero and ureteric anastomosis. RESULTS Open surgery was successfully performed in nine cases. The mean surgery time was 95.6±22.0 min, and blood loss was 108.6±34.5 mL. The mean hospitalization time was 14.8±1.1 days, and the recovery time was 52.8±1.3 days. Retroperitoneal laparoscopic surgery was successfully performed in five cases without conversion to open surgery and without severe perioperative complications. The mean surgery time was 112.0±42.1 min, and blood loss was 45.3±15.1 mL. The mean hospitalization time was 7.3±1.9 days, and the recovery time was 23.6±2.4 days. Postoperative urine leakage occurred in one patient. No postoperative ureter stenosis occurred in patients who were treated by retroperitoneal laparoscopic surgery. CONCLUSION Retroperitoneal laparoscopic ureteroplasty in patients with retrocaval ureter is safe and effective with less trauma and faster recovery and could be used as first choice for the treatment of retrocaval ureter.