Comparison of laparoscopic versus open dismembered pyeloplasty

Purpose. We evaluated the clinical value of our initial experience of laparoscopic dismembered pyeloplasty for ureteropelvic junction obstruction compared with open surgery. Materials and methods. The clinical data of 105 patients who underwent laparoscopic dismembered pyeloplasty were retrospectively compared with those of 150 patients who underwent open dismembered pyeloplasty (ODP) through a retroperitoneal flank approach. Results. Patient demographic data were similar between the 2 groups. In the laparoscopic group operative time was 163 vs 103 minutes of ODP, estimated blood loss was 31 vs 132 ml, ambulation of the patients was 1 vs 2 days, analgesic (diclofenac) requirements was 75 vs 300 mg per patient, mean incision length was 4.1 (summary of incisions for 4 port placement) vs 17 cm and postoperative hospital stay was 3 vs 8 days, respectively. All parameters were statistically significant in the laparoscopic group than in the open group (p <0.001 for all). No intraoperative complications occurred in either group. The incidence of the major postoperative complications (3 of 105, 3.0% vs 9 of 150, 6.0%, p = 0.729) and success rates (103 of 105, 98.1% vs 147 of 150, 98.0%) were equivalent in the both groups. Conclusions. Laparoscopic dismembered pyeloplasty is a minimally invasive, safe and effective therapy for ureteropelvic junction obstruction with low morbidity, shorter convalescence and excellent outcomes, and can be accomplished reasonably quickly in experienced hands.

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