Journal of X-Ray Science and Technology - Volume 21, issue 3

Authors: Wang, Xisheng | Zhang, Zejian | Peng, Naixiong | Liu, Chunxiao

Article Type: Research Article

Abstract: OBJECTIVE: To compare classical open pyeloplasty with retroperitoneal laparoscopic pyeloplasty in effectiveness, potential advantages and complications. MATERIALS AND METHODS: Between March 2006 and April 2010, 113 patients with ureteropelvic junction obstruction underwent retroperitoneal laparoscopic dismembered pyeloplasty were retrospectively compared with those of 59 patients who underwent open dismemberse pyeloplasty through a retroperitoneal flank approach. The Chi-square test was used for statistical analysis of qualitative data and the Student t-test for …analysis of quantitative data. P < 0.05 was considered significant. RESULTS: Operative time was shorter in the retroperitoneal laparoscopic group (mean 125 min) compared to the open pyeloplasty group (mean 142 min, P < 0.05). Mean hospital stay was shorter in the retroperitoneal laparoscopic group (mean 6 days, compared to 9 days, open). Complication rates, including anastomotic urinary leakage, stenosis and infection, were 4.42% in retroperitoneoscopic compared to 6.78% open surgery. Anastomotic leakage was 3 cases in the retroperitoneoscopic group versus 1 case in the open group. Success, defined as improved ultrasonic or renographic parameters, with resolution of symptoms where discernable, was noted in 98.0% of the open group and 98.1% of the retroperitoneoscopic group with a mean follow up of 38.4 and 32.7 months, respectively. CONCLUSIONS: Retroperitoneal laparoscopic dismembered pyeloplasty in treatment of ureteropelvic junction obstruction is a minimally invasive, safe and effective therapy with short procedure time, less complications, and shorter convalescence. Show more

Keywords: Ureteropelvic junction obstruction (UPJO), retroperitoneoscopic, pyeloplasty, open, comparison

DOI: 10.3233/XST-130394

Citation: Journal of X-Ray Science and Technology, vol. 21, no. 3, pp. 429-439, 2013

Authors: Luo, Daosheng | Liu, Guihua | Mo, Junhua | Xiao, Lihua | Xie, Qiang | Li, Mu | Zhang, Zengqiang | Lu, Jianjun | Liang, Zhenfeng | Meng, Xiangjun | Zhang, Yuanyuan | Deng, Chunhua | Mi, Qiwu

Article Type: Research Article

Abstract: This study was designed to evaluate the safety and efficacy of suprapubic-assisted umbilical laparoendoscopic mini-dual-site surgery (SAU-LEMDS) with satisfied cosmetic outcome in minimal size of surgical incision for the treatment of simple kidney cyst at large size. Twenty-six consecutive patients (16 male and 10 female), aged 48.5 ± 4.1 years (range: 18 to 70 years), were enrolled in this study. All cases had simple kidney cysts including 18 cases on the left side and 8 cases …on the right, with a mean cyst maximum diameter of 7.5 ± 0.8 cm. Under general anesthesia, the patients were placed in flank position with affected side elevated by 70°. Two trocars (5.5 mm in diameter) were inserted via the umbilical port. The third trocar was inserted into abdominal cavity above the pubic hairline for the placement of a 5-mm 30° laparoscope. The surgery procedures were successfully performed in the same manner as standard laparoscope-assisted kidney cyst decortication in all cases. The specimens were obtained through either of two umbilical ports without additional enlarge incisions. The mean operation time was 30 ± 8.2 min and the mean blood loss was 10.3 ± 2.1 ml. The duration of hospitalization was 4.2 ± 0.9 days, and the mean follow-up was two months (range: 1 to 3 months). Postoperatively, surgical wounds were small and healed well and cosmetic outcomes were satisfactory. No recurrent kidney cysts were found during follow up. SAU-LEMDS appears to be a feasible, safe and effective surgical option for simple kidney cyst, which not only leads to better cosmetic effects, but also decreases the complexity of umbilical laparoendoscopic single site surgery (U-LESS). Show more

Keywords: Laparoendoscopic mini-dual-site surgery (LEMDS), transumbilical surgery, pubic symphysis, kidney cyst

DOI: 10.3233/XST-130395

Citation: Journal of X-Ray Science and Technology, vol. 21, no. 3, pp. 441-447, 2013