Comparative Study Of Endoscopic And Open Surgeries For Some Urological Disease

BACKGROUND AND OBJECTIVE:The endoscopic technique is evolving rapidly in urology. This study compare the outcome of patients who underwent laparoscopic adrenalectomy (LA), laparoscopic radical nephrectomy (LRN), transurethral resections of the prostate (TURP) with those who had open operation.METHODS:A total of 288 patients with complete medical records were included in this study. 16 patients underwent LA, 17 patients received OA (open adrenalectomy), 14 patients underwent LRN, 53 patients received ORN (open radical nephrectomy) . 150 patients underwent TURP, 35 patients received SRP (suprapubic transvesical prostatectomy). The preoperative and intraoperative data analyses focused on specimen volume, specimen diameter, surgery time, length of preoperative stay, length of postoperative stay, blood plasm transfusion, RBC transfusion, hospital stay, total cost, surgical supplies, drug, chemical examination, room and board, management cost, nursing, operating cost, and examination cost.RESULTS:LA was completed in all 37 patients without conversion to OA or mortality. The operative times, the blood plasm transfusion, RBC transfusion were similar for both LA and OA groups. The hospital stay, length of preoperative stay, length of postoperative stay was similar for both LA and OA groups. The surgical supplies was higher in the LA group (2505.75vs. 892.99, p<0.001) and other cost were similar for both LA and 0A groups.14 patients with localized renal cell carcinoma who underwent LRN were retrospectively compared with those of 70 patients who underwent ORN. The mean operative time was longer in the LRN group (240 vs. 164 min, p <0.001.); The Surgical supplies (5977.08vs. 1029.97, p< 0.001), Operating cost (18688. 55vs. 13880.14, p<0.001), Total cost (3357. 38vs. 2454. 92, p=0. 002) was higher in the LRN group and other cost were similar for both LRN and ORN groups. The blood plasm transfusion, RBC transfusion, the hospital stay and length of postoperative stay were similar for both LRN and ORN groups.150 Patients were underwent TURP while 35 patients were underwent suprapubic transvesical prostatectomy (STP). Of all the evaluated parameters, the following statistically significant differences between the two groups were noted: The mean operative time (79. 21 vs. 118. 38 min, p<0.001.), catheter days (6.25 vs. 11. 74 day, p<0. 001.), the hospital stay (15.63 vs. 23.12 day, p<0.001), and length of postoperative stay (8.83 vs. 15.59 day, p<0.001) was shorter in the TURP group; The RBC transfusion (0.00 vs0.04u, p<0.001.) was lower in the TURP group; The surgical supplies (1665.75. vs. 934.29, p<0.001), operating cost (2312.52vs. 1693.45, p<0.001) was higher in the TURP group; The management cost (987.46. vs. 1489. 06, p<0.001), nursing cost (293.99vs. 334. 68, p=0.007) and room and board (258.66. vs. 385.12, p<0.001) was lower in the TURP group.CONCLUSIONS:LA and TURP results in good surgical outcome without increased cost. We suggest that LA and TURP should be the preferred-choice for management of adrenal lesions, benign prostatic hyperplasia. Although laparoscopic radical nephrectomy was underwent increasingly, the technique of LRN need be evolved gradually.