Comparative Study between Continuous and Interrupted Suturing in Laparoscopic Pyeloplasty

Abstract

Background: Ureteropelvic junction obstruction (UPJO) is a common cause of symptomatic ureteral obstruction. Dismembered pyeloplasty is the most commonly employed procedure for the repair of UPJO. Both interrupted and continuous suturing is being practiced in laparoscopy. As satisfactory anastomosis determines the success of dismembered pyeloplasty and recovery of renal function, the success rate and the complications associated with the suturing technique need to be evaluated. Objective: To compare the outcome between continuous and interrupted suturing in laparoscopic pyeloplasty. Methods: This hospital-based, quasi-experimental study was done in the Department of Urology, Dhaka Medical College Hospital (DMCH), Dhaka and the National Institute of Kidney Diseases & Urology (NIKDU), Dhaka from July 2022- June 2023. A total of 60 patients were purposively selected for the study. According to the suture method for ureteropelvic anastomosis, patients were divided into two groups: 30 patients (group A) underwent surgery with the continuous suture method, and 30 patients (group B) underwent surgery with the interrupted suture method. Data on suturing time, post-operative drain output, post-operative hospital stay and post-operative complications were collected. Patients were followed up at 01, 03 and 06 months. At 06 months, a DTPA renogram with split GFR was done to evaluate the patients. Results: The mean ages were 30.0 (±8.3) years for Group A and 33.9 (±9.3) years for Group B, with males comprising 56.7% and 63.3% of each group, respectively. Group B had significantly higher mean suturing time, post-operative drain output, and hospital stay compared to Group A (p<0.001). No significant differences in GFR were noted between the groups (p>0.05). Post-operative complications were observed in 10.0% of Group A and 23.3% of Group B (p=0.166). Conclusion: Continuous suturing technique for pyeloplasty is found to have a lower mean suturing time, mean drain output and post-operative hospital stay.