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Year : 2021  |  Volume : 6  |  Issue : 1  |  Page : 22-30

Role of ureterolysis in the management of retroperitoneal fibrosis: A systematic review

1 Department of Surgery, Interior Security Forces Hospital, La Marsa, Tunisia
2 Daytime Hospital Department, Interior Security Forces Hospital, La Marsa, Tunisia

Correspondence Address:
Dr. Rami Boulma
Department of Surgery, Interior Security Forces Hospital, La Marsa
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/bjhs.bjhs_60_20

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The purpose of the present study is to assess the outcome of ureterolysis in the management of ureteral entrapment secondary to retroperitoneal fibrosis (RPF). A literature search of online database PubMed for studies about ureterolysis was performed. The keywords used for this literature review were: “Retroperitoneal fibrosis” and “Ureterolysis.” Articles in English published between 1980 and 2019 were included. Articles published in non-English language, without full text or lacking of relevant data, were excluded. Clinical perioperative and outcome data were collected, analyzed, and compared between open, laparoscopic, and robotic ureterolysis subgroups. Postoperative complications were recorded according to the Clavien classification. One hundred and six articles were initially collected. After analysis, 37 articles were finally selected for the review. The number of patients was 402. The number of renal units was 554. The median age of our population was 54.55 years (36.5–71). The male/female ratio was 1.71. RPF was idiopathic in 312 patients (77.61%). Ureterolysis was bilateral in 131 cases. The mean success rate in open ureterolysis was 90.45% (77%–100%), the mean success rate in laparoscopic ureterolysis was 93.72% (77.8%–100%), and the success rate in robot-assisted ureterolysis was 100%. Most complications were Clavien I and II. Clavien V was noted in four patients. Ureterolysis is an effective treatment in the management of ureteral entrapment in RPF. It is a safe procedure with possible but manageable complications. It can be proposed in cases of medical therapy failure.

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