Study On Laparoscopic Pyeloureterolithotomy Versus Open Surgery In Respect Of Therapeutic Effects

Objective:To study the therapeutic effects of abdominal laparoscopic pyeloureterolithotomy and open surgery for treating calculus in renal pelvis and upper segment ureteral calculi,and then to evaluate the value of laparoscopic.Materials and Methods:Materials:There are 84 patients with pyelic calculi or ureteral calculi included in this study,they are all underwent pyeloureterolithotomy in Shandong University Qilu Hospital from January 2005 to December 2009.30 by abdominal laparoscopic;54 by open surgery.Surgical technique:The group of laparoscopic use the transperitoneal pathway;the group of open surgery use the traditional way.Statistical analysis:The data of basics(age,sex,height,weight,medical history),stone characteristics(size,location),operation(operating time,bleeding volume),complicati-on rate,postoperation(recovery of intestinal,ambulation after operation,penrose drain days),days of hospitai stay,cost of hospitalization were analyzed retrospectively.Data were analysed using SPSS16.0.Data was indicated with mean±s. To compare the numerical variable,such as operating time,the t test was used;variables with the normal distribution,such as age,were compared by X2 test.Results:Two patients in laparoscopic group ended up in open surgery,others in laparoscopic group and open surgery group were successed.The basics (ages,sex,height,weight,medical history),stone characteristics (size,location) showed no significant differences.In laparoscopic group,the operating time:183±65min,bleeding volume:13.6±7.7ml,complication rate:2/30,recovery of intestinal:1.2±0.5d,ambulation after operation:1.3±0.6d,penrose drain days:4.7±2.2d,days of hospital stay:15.9±5.5d,cost of hospitalization:17944.6±2544.1;the datas in open surgery:120±60min,99.4±62.5ml,3/54,2.6±1.3d,2.7±1.1d,4.6±1.5d,18.3±9.8d,12092.6±2516.9yuan.There are no significant differerces between the two groups in complication rate and penrose drain days.While the operating times average bleeding volume in operation,recovery of intestinal,ambulation after operation,hospital stay and cost of hospitalization show significant differences(P<0.05).Conclusion:1,There are no obviously differences on the indication,safety and feasibility between abdominal laparoscopic pyeloureterolithotomy and open surgery.2,Group laparoscopic had less average bleeding volume in operation,recovery of intestinal,ambulation after operation and shorter hospital stay than group open surgery3,While in group open surgery,the operating time and cost of hospitalization were less than the other. With the raise of experience and competence,the operating time of laparoscopic could be equal to open surgery,evev less.4,Laparoscopic pyeloureterolithotomy had the characteristics of mini-invasion,little bleeding and quick recovery,may replace open surgery under given conditions.