Laparoscopic versus open pyeloplasty in the management of ureteropelvic junction obstruction

Abstract

Objectives This study aimed to compare the results and outcome of laparoscopic versus open pyeloplasty in the management of ureteropelvic junction obstruction. Background Since the first successful open pyeloplasty in 1891 by Kuster, many approaches for ureteropelvic junction obstruction correction has been developed. Successful laparoscopic pyeloplasty was initially introduced by Schuessler in 1993. Laparoscopic pyeloplasty has decreased morbidity of flank incision and shorter hospital stay with excellent surgical outcomes. Materials and methods This study was conducted as a prospective nonrandomized study at the urology department, faculty of medicine, Menoufia University, Egypt. A total of 30 patients were included and divided into two groups. The first group included 21 patients who underwent open pyeloplasty between May 2010 and June 2013. The second group included nine patients who underwent laparoscopic pyeloplasty between June 2010 and May 2013. Preoperative, intraoperative, and postoperative variables and outcome were evaluated. Results Demographic data for patients in the two groups were similar. There were 21 patients (eight male and 13 female patients) in the open group, with a mean age of 23 ± 5.5 (17–38), versus nine patients (four male and five female patients) in the laproscopic group, with a mean age of 23 ± 3.8 (18–27). Compared with the open group, the laparoscopic group had prolonged operative time (251 ± 55.7 vs. 129 ± 20.7). The mean follow-up period was 18.5 versus 18.8 for the open group and the laparoscopic group, respectively. During the 3-month follow-up period, postoperative glomerular filtration rate% and postoperative T1/2 per minutes were comparable in both groups, without statistical difference; they were 33 ± 11.8 and 12 ± 8.7 versus 35 ± 11.7 versus 16 ± 14.5 for the open group and the laparoscopic group, respectively. Conclusion Perioperative complications, hospital stay, and success rate are comparable between open and laparoscopic pyeloplasty, with prolonged operative time for the laparoscopic group and larger morphine equivalent dose for the open group.