Clincial study on 3D laparoscopic disconnected pyeloplasty via retroperitoneal approach

Abstract

Objective To investigate the efficacy of 3D laparoscopic disconnected pyeloplasty via retroperitoneal approach. Methods The clinical data of 78 patients with ureteropelvic junction obstruction in the First Affiliated Hospital of Zhengzhou University from July 2015 to July 2017 were retrospectively analyzed. Preoperative diagnosis of ultrasound and CT was performed in the 78 cases. According to surgical methods, the 78 cases were divided into 3D laparoscopic group (42 cases) and 2D laparoscopic group (36 cases). Demogeaphic data (sex, age, obstruction site, body mass index, hydronephrosis) and perioperative data (surgery time, cutting and anastomosis time, amount of bleeding, postoperative hospital stay) were collected. Results All operations were completed successfully without open convertion. The operation time of the 3D laparoscopic group and the 2D laparoscopic group were (95±9) min and (113±12) min respectively. The perioperative bleeding volume were (54±6) ml and (53±8) ml in 3D and 2D laparoscopic group, respectively; the postoperative hospitalization time were 7.00 (7.00 to 7.00) d, 7.00 (7.00 to 7.00)d, there were no significant difference between the two groups (P all>0.05). The follow-up time was 12 to 42 months, with an average of 27 months. There was 1 case of recurrent stenosis and hydronephrosis in each group. And the two patients were improved after endoscopic dilatation. In the 2D laparoscopic group, a small amount of urine leakage occurred in 2 cases, and healed after 1 week. There was no significant difference in the incidence of complications between the two groups (2.4%vs.2.8%), P>0.05. Conclusions 3D laparoscopic disconnected pyeloplasty via retroperitoneal is safe and feasible. Compared with 2D laparoscopic surgery, 3D laparoscopic surgery can increase the accuracy of cutting and anastomosis, reduce the difficulty of surgery, and shorten the operation time. Key words: 3D laparoscopy; 2D laparoscopy; Ureteropelvic junction obstruction; Disconnected pyeloplasty; Retroperitoneal approach; Efficacy