Comparison Of Therapeutic Effects Between Retroperitoneal Laparoscopic Pyeloureterolithotomy And Open Surgery

Objective: To compare the therapeutic effects of retroperitoneal laparoscopicpyeloureterolithotomy and open surgery and evaluate the advantages of laparoscopy.Methods: Between January2009and October2011,79patients from DalianMunicipal Center Hospital underwent pyeloureterolithotomy,45by retroperitoneallaparoscopic and34by open surgery. Data were retrospectively analyzed includingoperative time, blood loss, intestinal recovery time, postoperative drainage time,painkillers application, stones clearance, postoperative length-of-stay in-hospital,hospital charges and complications. Double J tube was not placed in patient withoutureteral stricture, inflammatory thickening of the ureter, ureteral polyps, or with anincision less than1.0centimeters. Comparison was made between patients with andwithout Double J tube in operative time, postoperative length-of-stay in-hospital,hospital charges, ureteral leakage and stricture. The software SPSS11.5was used toprocess the data. Measurement data was analyzed by t test and counting data bychi-square test with P <0.05as statistical significance.Results: There were shorter intestinal recovery time and postoperativelength-of-stay in-hospital, less painkillers application, less incision numbness andabdominal wall bulge in the laparoscopic group than in open group (P<0.05). Hospitalcharges was lower in the open group.(P<0.05). There were no significant differences inoperative time, blood loss, postoperative drainage time, stones clearance, incisioninfection, ureteral leakage and stricture between the two groups. There were nosignificant differences in operative time, postoperative hospitalization time, hospitalcharges, leakage and ureteral stricture between Double J group and no double J group.Conclusions: There were no differences between the laparoscopic group and theopen group with relation to stone clearance, ureteral leakage and stricture. Thelaparoscopic group had advantages of less pain, less incision numbness and abdominal wall bulge. Despite the slightly higher hospital charges, Laparoscopic surgery is anideal surgery for renal pelvis and ureter stones because of less trauma and pain, quickerrecovery and fewer complications.