MP04-17 SUPRAPUBIC-ASSISTED LAPAROENDOSCOPIC SINGLE-SITE SURGERY VERSUS OPEN URETEROVESICAL REIMPLANTATION USING INSERTION METHOD

Abstract

You have accessJournal of UrologySurgical Technology & Simulation: Instrumentation & Technology I (MP04)1 Apr 2020MP04-17 SUPRAPUBIC-ASSISTED LAPAROENDOSCOPIC SINGLE-SITE SURGERY VERSUS OPEN URETEROVESICAL REIMPLANTATION USING INSERTION METHOD Guoxi Zhang*, Xiaofeng Zou, Liang Wang, and Rihai Xiao Guoxi Zhang*Guoxi Zhang* More articles by this author , Xiaofeng ZouXiaofeng Zou More articles by this author , Liang WangLiang Wang More articles by this author , and Rihai XiaoRihai Xiao More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000818.017AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To compare the efficacy of suprapubic-assisted laparoendoscopic single-site surgery (SA-LESS) and open ureterovesical reimplantation using insertion method, and to evaluate its clinical value. METHODS: Thirty patients who underwent SA-LESS ureterovesical reimplantation and 32 patients who underwent open ureterovesical reimplantation using insertion method were selected from July 2010 to December 2016 in the Department of Urology, First Affiliated Hospital of Gannan Medical College. To collect the material such as gender, age, preoperative water accumulation, operation time, intraoperative blood loss, postoperative complications, postoperative day 1 visual analog simulation score (Visual Analogue Scale/Score, VAS), postoperative analgesia time, postoperative ventilation time, postoperative drainage withdrawal time, postoperative catheter indwelling time, postoperative hospital stay. The main clinical items were compared and analyzed. All patients were reexamined 3 months, 6 months and 12 months after operation, and then every year. The follow-up included urinary color Doppler ultrasound, urinary analysis, renal function, intravenous urography and cystography, and patient scar assessment questionnaire. The differences of intraoperative and postoperative items between the two groups were compared. RESULTS: All 30 patients in the SA-LESS group were successful with no open surgery, no addtion port. 32 cases of the open group were successfully operated. No significant differences were found in operative time [(116.7±25.2)min vs (107.9±16.4)min, P=0.065], and postoperative catheter indwelling time [(8.0±1.8)d vs (8.9±2.1)d, P=0.088] between the two groups. Significant differences in intraoperative blood loss [(61.2±37.8)ml vs (110.8±39.1)ml, P=0.000], intraoperative incision length [(2.7±0.3)cm vs (12.8±2.4)cm, P=0.000], and postoperative intestinal function recovery time [(36.0±13.9)h vs (50.2±18.4)h, P=0.001] between the two groups were found. Significant differences in VAS score on the first postoperative day [(2.1±1.0) vs (3.8±1.2), P=0.001], VAS score on the third day after surgery [(1.0±1.0) vs (1.8±1.2), P=0.009], and postoperative analgesia time [(22.8±14.6)h vs (37.2±14.5)h, P=0.000] between the two groups were also found. There were significant differences in postoperative drainage tube indwelling time [(4.4±1.5)d vs (5.9±2.4)d, P=0.003],and postoperative hospital stay [(9.1±2.0)d vs (11.0±3.1)d, P=0.003] between the two groups. Complications occurred in 2 patients in the SA-LESS group, all of which were anastomotic leakage. In the open group, 9 patients had complications after operation. Among them, 4 patients had anastomotic leakage and 5 patients developed a wound infection. Significant difference was found in complication rates (x2=4.885, P=0.027). The total PSAQ of the SA-LESS group was lower than that of the open group at 3 months, 6 months and 1 year [(61.9±8.7) vs (85.9±8.3), P=0.000; (48.2±6.4) vs (74.0±8.2), P=0.000; (37.5±4.8) vs (64.9±6.3), P=0.000]. The SA-LESS group was followed up for 24-90 months, and the open group was followed up for 28-91 months. All cases were followed up for B-ultrasound and IVU, and postoperative hydronephrosis was improved to varying degrees. All cases were followed up for cystoscopy and no ureteral reflux was seen. CONCLUSIONS: SA-LESS ureterovesical reimplantation using insertion method, can result in small trauma, rapid postoperative recovery, less complications, and better cosmetic results with stable, long-term postoperative effect, which is worthy of application in clinic. Source of Funding: National Nature Science Foudation of China (Grant no. 81760462) © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e38-e39 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Guoxi Zhang* More articles by this author Xiaofeng Zou More articles by this author Liang Wang More articles by this author Rihai Xiao More articles by this author Expand All Advertisement PDF downloadLoading ...