A Comparative Study On The Efficacy Of Laparoscopic And Open Andersen-Hynes Operation In The Treatment Of UPJO In Children

Objective(s):In this study,the effects,advantages and disadvantages of laparoscopy and open Andersen-Hynes operation on the treatment of ureteropelvic junction obstruction(UPJO)are compared,to explore the safety and feasibility of laparoscopic Andersen-Hynes operation in children,to provide more basis for future laparoscopic Andersen-Hynes operation in children with UPJO.Methods:Retrospective analysis of 77 children with UPJO admitted to the Second Affiliated Hospital of Kunming Medical University from January 2017-to June 2019,The urinary B-ultrasound,CT or CTU,MRU and other tests were completed before the operation.The pathological results after the operation were muscular stenosis of the pelvic and ureteral junction.Divided into laparoscopic group(LP group)and open group(OP group)according to the operation,comparing general case data and surgical data respectively.All data in the experiment were analyzed using SPSS 21.0 statistical software,and the results considered that P<0.05 was statistically different.Results:There were no statistical differences between the two groups in general case data such as age,gender,cause of consultation,side of lesion,degree of hydronephrosis at the time of consultation.etc.In the comparison of surgical data,the operation time in the LP group was longer than that in the OP group(P=0.01),and the difference was statistically significant,and the difference was statistically significant.The intraoperative blood loss was significantly less in the LP group than in the OP group(P<0.001),and the difference was statistically significant.Total perirenal drainage in the LP group was less than in the OP group(P<0.001),and the difference was statistically significant.The use of analgesics in the LP group was lower than that in the OP group(P<0.001),and the difference was statistically significant.The number of hospital stays in the LP group was less than that in the OP group(P<0.001),and the difference was statistically significant.The hospitalization cost of the LP group was significantly higher than that of the OP group(P<0.001),and the difference was statistically significant.There was no statistical difference in antibiotic use(P=0.073),postoperative complications(P=0.499),postoperative renal hydrops remission rate(P=0.801),and surgical success rate(P=0.847).Conclusion(s):1.Llaparoscopy and open Andersen-Hynes operation are equally safe and effective in treating UPJO;2.Compared with open Andersen-Hynes operation,laparoscopic Andersen-Hynes operation has less trauma,less bleeding,quick postoperative recovery,shorter average postoperative hospital stay,larger operation space,and more accurate suture.And it can be recommended as a surgery for UPJO in children.