| Objective:To investigate and compare the trobotic-assisted laparoscopic,laparoscopic open of pyeloplasty for treating ureteropelvic junction obstruction.Methods:71 cases in our hospital patients with UPJ obstruction during October 2013 in March 2016,according to the principle of random draw.The patients were given pyeloplasty treatment in thre e different ways,including robotic-assisted laparoscopic pyeloplasty group(RALP,16 cas es),laparoscopic pyeloplasty group of(LP,20 cases),and open pyeloplasty group(OP,35cases).Their differences are compared between groups in operation time,intraoperative blood loss,postoperative perirenal drainage flow a mount,days of perirenal drainage tube withdrawal,hospital stays and cost,as well aspostoperative complication and postoperative recurrence of hydronephrosis.Application of SPSS 16.0 statistical software for snalysis,P<0.05 was consider statistically significant.Results:All patients were succe ssfully completed operation,it was not happened that RALP or LP were turned into OP.In the RALP group,the average operation time was(72.69 + 16.78)m in,the average intraopera tive blood loss was(21.25 + 8.85)m l,the average postoperative perirenal drainage flow am ount was(30.94 + 12.94)m l,the average days of perirenal drainage tube withdrawal were(2.63 + 0.72)days,the average hospital stays were(4.19 + 0.91)days,the average hospitalcost was(46055 + 5181.1)yuan,RALP group have 1 case of urinary tr act infection,and 1 case of pul monary infection;In the LP group,the average operation time was(125.60 + 35.36)m in,the average intraoperative blood loss was(52.50+27.60)ml,the average postoperative perirenal drainage flow amount was(53.25 + 21.42)ml,the average days of perirenal drainage tube withdrawal were(3.95 + 1.54)days,the average hospital stays were(5.90 + 0.85)days,the average hospitalcost was(25134 + 7740.3)yuan,LP group have 3 cases of urinary tract infection,1 case of urinary leakage;In the OP group,the average operation time was(127.40±42.64)m in,the average intraoperative blood loss w as(67.71 + 28.50)m l,the average postoperative perirenal dr ainage flow a mount was(74.86 + 37.43)ml,the average days of perirenal drainage tube withdrawal were(6.94 + 0.91)days,the average hospital stays were(5.90 + 0.85)days,the average hospitalcost was(20384 + 6259.5)yuan,LP group have 3 cases of urinary tract infection,2 cases of urinary leakage,1 case of bleeding.Com paring with these three groups,there were no significant differences between the sex,the age,the body mass index(BMI),the American society of anesthesiologists(ASA)and the side of operation.In terms of operation time,the RALP group is much shorter than LP group and OP group(P<0.001).However,there is no difference between LP group and OP group.As to intraoperative blood loss,postoperative perirenal drainage flow a mount,days of perirenal drainage tube withdrawal,hospital stays and cost,the figure shows that there are significant differences among these three group(P<0.05).Besides,the LP seems to be better than the OP when comparing the indicators in operation.RALP further expand the advantage,although its cost is the highest.Nevertheless,the data shows no difference in operative complications among these three groups(P>0.05).All patients were followed up for 2-31 m onths after the operation,received BU S,IVU,MRU,renogram or other reexamination for,and were proved that the obstruction disappeared and the hydronephrosis alleviated.The renal function also got improved.Conclusion:Compared with open surgery,laparo scopic surgery has no significant difference in safety and feasibility.Laparosc opic surgery has the advantages of less bleeding,less trauma,less pain,faster pos toperative recovery and so on,it’s the development trend of treatment for uret eropelvic junction obstruction.The robot assisted laparoscopic surgery system with three-dimensional surgical field,amplification,these advantages more effectively reduces the difficulty of conventional laparoscopic surgery complex,reduce the da mage to the organization,especially suitable for tissue and organ function reconstruction.RALP will gradu ally replace the LP and OP surgical approach,in the conditional hospital as a new choice for the treatment of UPJO. |
