Boylu Ugur, Basatac Cem, Turan Turgay, Onol Fikret Fatih, Gumus Eyup
Department of Urology, Umraniye Teaching Hospital, Istanbul, Turkey.
J Laparoendosc Adv Surg Tech A. 2012 Dec;22(10):968-71. doi: 10.1089/lap.2012.0142. Epub 2012 Oct 26.
To compare the surgical and functional outcomes of minimally invasive pyeloplasty versus open pyeloplasty.
Between 2008 and 2010, 20 patients underwent transperitoneal minimally invasive (13 robot-assisted and 7 laparoscopic) pyeloplasty, and 22 patients underwent conventional open pyeloplasty. Operative and functional outcomes were compared between the minimally invasive and open pyeloplasty groups. The statistical analysis was performed using Fisher's exact test, unpaired t test, and Mann-Whitney U test.
The mean age was 31 years in the minimally invasive group and 27 years in the open group. The mean operative time was 131 minutes in the minimally invasive group and 128 minutes in the open group (P=.71). The estimated blood loss was 30 mL in the minimally invasive group and 108 mL in the open group (P=.001). The drain was removed after 1.75 days and 4.48 days in the minimally invasive and open groups, respectively (P=.001). The mean hospital stay was 1.94 days and 4.19 days in the minimally invasive and open groups, respectively (P=.001). Crossing vessels were observed in 21% of all patients, and the transposition of the ureter was performed in all patients with an anterior crossing vessel. One patient in each group had symptomatic and radiographic recurrence and persistently obstructed drainage pattern on diuretic renography. The radiographic and symptomatic success rate was 95% in the minimally invasive group and 95.5% in the open group.
Minimally invasive pyeloplasty has low morbidity, short length of stay, and less blood loss compared with open surgical repair. It is an effective and feasible minimally invasive treatment modality for ureteropelvic junction obstruction.
比较微创肾盂成形术与开放性肾盂成形术的手术及功能效果。
2008年至2010年间，20例患者接受了经腹微创（13例机器人辅助和7例腹腔镜）肾盂成形术，22例患者接受了传统开放性肾盂成形术。比较微创和开放性肾盂成形术组的手术及功能效果。采用Fisher精确检验、非配对t检验和Mann-Whitney U检验进行统计学分析。
微创组平均年龄为31岁，开放组为27岁。微创组平均手术时间为131分钟，开放组为128分钟（P = 0.71）。微创组估计失血量为30毫升，开放组为108毫升（P = 0.001）。微创组和开放组分别在术后1.75天和4.48天拔除引流管（P = 0.001）。微创组和开放组平均住院时间分别为1.94天和4.19天（P = 0.001）。在所有患者中，21%观察到交叉血管，所有有前交叉血管的患者均进行了输尿管移位。每组各有1例患者出现症状性和影像学复发，利尿肾图显示引流模式持续梗阻。微创组的影像学和症状缓解成功率为95%，开放组为95.5%。
与开放性手术修复相比，微创肾盂成形术具有发病率低、住院时间短和失血量少的特点。它是治疗输尿管肾盂连接处梗阻的一种有效且可行的微创治疗方式。
