Is laparoscopic pyeloplasty a comparable option to treat ureteropelvic junction obstruction (UPJO)? A comparative study

Objective: To compare laparoscopic with open pyeloplasty. Methods: The retrospective study was conducted at Aga Khan University Hospital, Karachi, and comprised records of patients who underwent surgical correction of ureteropelvic junction obstruction between during January 2008 and December 2012. Patients with laparoscopic pyeloplasty were placed in group 1 and those with open pyeloplasty in group 2.The groups were compared for operative time, hospital stay, perioperative complications, blood loss, duration of surgery, outcome and follow-up. Data was analysed using SPSS 19. Results: Of the 73 patients, 29(40%) were in group 1, and 44(60%) in group 2. A crossing vessel could be identified in 25(86.2%) in group 1 and in 33(75 %) in group 2. Laparoscopic procedures were associated with a longer mean operating time (p=0.04),median estimated blood loss (p<0.001) and a shortermean hospital stay (p<0.001). Followup mercaptoacetyltriglycinescan was done in 21(74.5%) patients in group 1 and 23(52.2%) in group 2. Only 2(7%) patients in group 1 and 2(4.5%) in group 2 had poor response onmercaptoacetyltriglycine scan.Mean follow-upwas 2.71±1.2 months. Postoperative complications were 5(13%) in group 1 and 9(20%) in group 2(p=0.141). Conclusion: Laparoscopic pyeloplasty was associated with shorter hospital stay, less pain and less blood loss. The efficacy in termof success rate and perioperative complications of laparoscopic pyeloplasty was comparable to that of open pyeloplasty.