Memon Mazhar Ali, Biyabani Syed Raziuddin, Ghirano Rajab, Aziz Wajahat, Siddiqui Khurram Mutahir
Department of Surgery, Section Urology, Aga Khan University Hospital, Karachi, Pakistan.
J Pak Med Assoc. 2016 Mar;66(3):324-7.
To compare laparoscopic with open pyeloplasty.
The retrospective study was conducted at Aga Khan University Hospital, Karachi, and comprised records of patients who underwent surgical correction of ureteropelvic junction obstruction between during January 2008 and December 2012. Patients with laparoscopic pyeloplasty were placed in group 1 and those with open pyeloplasty in group 2.The groups were compared for operative time, hospital stay, perioperative complications, blood loss, duration of surgery, outcome and follow-up. Data was analysed using SPSS 19.
Of the 73 patients, 29(40%) were in group 1, and 44(60%) in group 2. A crossing vessel could be identified in 25(86.2%) in group 1 and in 33(75 %) in group 2. Laparoscopic procedures were associated with a longer mean operating time (p=0.04), median estimated blood loss (p<0.001) and a shorter mean hospital stay (p<0.001). Follow-up mercaptoacetyltriglycinescan was done in 21(74.5%) patients in group 1 and 23(52.2%) in group 2. Only 2(7%) patients in group 1 and 2(4.5%) in group 2 had poor response on mercaptoacetyltriglycine scan. Mean follow-up was 2.71±1.2 months. Postoperative complications were 5(13%) in group 1 and 9(20%) in group 2(p=0.141).
Laparoscopic pyeloplasty was associated with shorter hospital stay, less pain and less blood loss. The efficacy in term of success rate and perioperative complications of laparoscopic pyeloplasty was comparable to that of open pyeloplasty.
比较腹腔镜肾盂成形术与开放性肾盂成形术。
本回顾性研究在卡拉奇的阿迦汗大学医院进行，纳入了2008年1月至2012年12月期间接受输尿管肾盂连接部梗阻手术矫正的患者记录。接受腹腔镜肾盂成形术的患者归入第1组，接受开放性肾盂成形术的患者归入第2组。比较两组的手术时间、住院时间、围手术期并发症、失血量、手术时长、结局及随访情况。使用SPSS 19对数据进行分析。
73例患者中，第1组29例（40%），第2组44例（60%）。第1组25例（86.2%）和第2组33例（75%）可识别出交叉血管。腹腔镜手术的平均手术时间较长（p = 0.04），估计中位失血量较多（p < 0.001），平均住院时间较短（p < 0.001）。第1组21例（74.5%）患者和第2组23例（52.2%）患者接受了随访巯基乙酰三甘氨酸扫描。第i组仅例（7%）患者和第2组2例（4.5%）患者巯基乙酰三甘氨酸扫描反应不佳。平均随访时间为2.71±1.2个月。第1组术后并发症为5例（13%），第2组为9例（20%）（p = 0.141）。
腹腔镜肾盂成形术住院时间较短、疼痛较轻、失血量较少。腹腔镜肾盂成形术在成功率和围手术期并发症方面的疗效与开放性肾盂成形术相当。
