Comparative Study Of Transumbilical Laparoendoscopic Single-site Surgery And Conventional Laparoscopy In The Treatment Of Pediatric UPJO

Objective:Analyze the clinical data of transumbilical laparoendoscopic single-site pyeloplasty and conventional laparoscopic pyeloplasty in the treatment of ureteropelvic junction obstruction in children,and evaluate the safety,effectiveness and clinical value of transumbilical laparoendoscopic single-site surgery.Methods:Retrospective analysis the information of 73 cases of pediatric ureteropelvic junction obstruction that met the clinical and pathological diagnosis from September 2015 to October 2019 in Department of Pediatric Surgery,the First Affiliated Hospital of Guangxi Medical University.According to the different surgical methods,they were divided into conventional group and single-site group.The differences of general data,intraoperative data,postoperative clinical data and postoperative follow-up data between the two groups were compared and analyzed.Results:Of the 73 medical records,67 were males and 6 were females;the lesions were located on the left side in 46 cases,and the right side was in 27cases;of which 27 were from 0 to 12 months,24 cases from 13 to 60 months,and 22 cases from 60 to 192 months,with the average age of whole group 43.66months.Of the 23 case data in the conventional group,1 case was converted to open surgery due to difficulty in placing the double J tube during operation;of the 50 case data in the single-site group,4 cases required additional auxiliary trocar during operation.In 2 patients,it was difficult to place double J tubes during operation and finally placed the external stent tube.The remaining operations were successfully completed.There were no statistically significant difference in the two groups of patients in terms of gender,lesion location,BMI,anteroposterior diameter before operation,glomerular filtration rate,average operation time,average bleeding volume,intraoperative blood oxygen saturation,postoperative anteroposterior diameter and glomerular filtration,drainage tube removal time,urinary tract infection rate,and urinary leakage rate,anastomotic stenosis rate（P>0.05）.The differences in mean age,intraoperative blood gas HCO₃^-level,postoperative feeding time,postoperative average hospital stay,and anteroposterior diameter of the pelvis before and after surgery were statistically significant（P<0.05）.The average age of the single-site group was significantly younger than that of the conventional group,intraoperative blood gas HCO₃^-level was lower than conventional group and the postoperative feeding time and the average length of hospital stay were significantly shortened.The postoperative anteroposterior diameter in the conventional group and the single-site group was significantly smaller than that before the operation,and the difference was statistically significant（P<0.05）.Conclusion:Transumbilical laparoendoscopic single-site surgery is safe and feasible in the treatment of children with UPJO.It is suitable for UPJO in children.It can obtain satisfactory clinical and cosmetic effects after surgery and has clinical promotion value.