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KMID : 0358320080490070592
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Korean Journal of Urology
2008 Volume.49 No. 7 p.592 ~ p.597
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A Comparison of Minimally Invasive Surgical Techniques for Ureteropelvic Junction Obstructions: Endopyelotomy, Acucise Endopyelotomy, and Laparoscopic Pyeloplasty
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Han Dong-Youp
Park Kwang-Sung
Seo Ill-Young
Rim Joung-Sik
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Abstract
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Purpose:The aim of this study was to compare the efficacy and outcomes of endopyelotomy, Acucise endopyelotomy, and laparoscopic pyeloplasty for patients with ureteropelvic junction obstructions.
Material and Methods :We studied 45 patients with ureteropelvic junction obstructions who underwent minimally invasive surgeries between January 2001 and April 2007. Patients were divided into three groups according to operative procedure: group I, endopyelotomy(n=17); group II, Acucise endopyelotomy(n=12; and group III, laparoscopic pyeloplasty(n=16).
Results:The mean patient ages in the three groups were 42.7±17.2 years, 48.8±14.1 years, and 49.5±13.6 years for groups I, II, and III, respectively. The mean stricture lengths were 0.99±0.25cm, 0.93±0.10cm, and 1.03±0.38 cm for groups I, II, and III, respectively, and were not significantly different among the groups(p＞0.05). The mean operating time for group II(55.7±25.3 minutes) was shorter than that for group I(131.7±30.5 minutes) and group III(165.2±23.7 minutes)(p＜0.05). The length of hospital stay for group II(4.7±1.6 days) was shorter than that for group I(6.6±1.8 days) and group III(7.4±0.6 days)(p＜0.05). Rates of symptomatic improvement were 58.8%, 66.7%, and 93.8% for groups I, II, and III, respectively. Rates of radiologic improvement were 58.8%, 66.7%, and 93.8% for groups I, II, and III, respectively. There was no significant correlation between success rate and either stricture length or degree of hydronephrosis.
Conclusion:Laparoscopic pyeloplasty had the highest success rate among the minimally invasive surgeries for patients with ureteropelvic junction obstructions. However, when the stricture length is less than 1cm in length, Acucise endopyelotomy may be considered as the first treatment because the associated operating time and hospital stay are short.
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KEYWORD
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Ureteroscopy, Acucise, Endopyelotomy, Laparoscopy
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