Comparison of two different suture methods in laparoscopic dismembered pyeloplasty.

OBJECTIVE

Anastomosis of ureteropelvic junction with a laparoscope for the treatment of ureteropelvic junction obstruction (UPJO) is a time-consuming and technically challenging procedure. We present our experience of laparoscopic dismembered pyeloplasty and compare clinical outcomes of two different suture techniques.

METHODS

From September 2003 to June 2010, 105 laparoscopic dismembered pyeloplasties were performed in our department. All procedures were done using the retroperitoneal approach. According to the suture methods (interrupted or running), the patients were divided into two groups. An indwelling stent was placed intraoperatively in an antegrade manner. Data on operation time, blood loss and complications were collected.

RESULTS

All procedures were completed without open conversion. Mean operation time and anastomotic time were 96 (55-150) and 36 min (15-70), respectively. A significant decrease of operation and anastomosis time was seen when running sutures were applied. Mean blood loss was 54 ml (30-100). The total complication rate was 7.6%. No anastomotic stricture occurred. The average hospitalization stay was 7 days. During 5-85 months of follow-up, hydronephrosis was alleviated in all cases.

CONCLUSIONS

Laparoscopic dismembered pyeloplasty for the treatment of UPJO can provide satisfactory clinical outcomes. Higher surgical efficiency and lower complication rates can be obtained by using the running suture method.