Comparison Of Therapeutic Effects Between Retroperitoneal Laparoscopic Pyeloureterolithotomy And Open Surgery

【Objective】To evaluate the surgical therapeutic effects between retroperitoneallaparoscopic pyeloureterolithotomy and open surgery intreating pelvic and ureteral calculi.【Methods】From January2010to December2013，date of patients who wentthrough pyeloureterolithotomy were collected retrospectively in upper urinary tractcalculi at the Union Hospital of Fujian medical University, including101cases ofretroperitoneoscopic group and70cases of open group. Operating time, blood loss,anal exhaust time, mean eating time, postoperative ambulation, postoperative drainagetime, postoperative complication rate, ration of the remained calculi, postoperativeanalgesia drug use, postoperative hospitalization time and hospitalization expenseswere compared between two groups.【Results】 All operations were successfully performed and only tworetroperitoneal laparoscopic cases were transferred to opening pyeloureterolithotomydue to seriousperirenal adhesions and operative arterial bleeding. The blood loss（42.43±28.17ml vs151.51±266.25ml）, anal exhaust time （1.15±0.36d vs2.29±0.92d）, mean eating tim（e1.73±0.66d vs2.44±0.91d）, postoperative ambulation（2.25±1.23d vs2.08±0.93d）, ration of the remained calculi[1(0.99%) vs8(11.43%)],postoperative complication rate [15(14.85%) vs21(30.00%)], postoperativehospitalization time （6.73±2.65d vs9.70±6.91d） and hospitalization expenses（21991.77±6696.36RMB vs24764.76±9655.87RMB） in the retroperitoneallaparoscopic group was superior to that of open group (P<0.05). The operatingtime(137.4±50.13min vs162.86±109.4min), postoperative drainage time（5.03±2.80d vs5.63±2.17d） and postoperative analgesia drug use（6.67±6.07vs7.05±7.49） were similar between two groups(P>0.05)． 【Conclusion】 Retroperitoneal laparoscopic pyeloureterolithotomy, as aminimally invasive means of treatment of renal pelvic and ureteral calculi, has lesstrauma and blood loss, faster postoperative recovery, lower incidenceof complication and less expensive. Its technology is more mature than before andcould partly replace traditional open surgery. But in real application, we should takeall factors into consideration, such as patient’s condition, economic condition andsurgeon’ skill in selecting a suitable patient.