Modified anastomosis for the improvement of learning curve in retroperitoneal laparoscopic dismembered pyeloplasty

doi:10.3877/cma.j.issn.1674-3253.2018.04.008

Abstract

Abstract:

Objective

To evaluate the perioperative outcomes and explore the improvement of learning curve of modified anastomosis for retroperitoneal laparoscopic dismembered pyeloplasty.

Methods

A total of 33 cases of uretero-pelvic junction obstruction (UPJO) with mean age of 17 (4-41) years were recruited for pyeloplasty since April 2015 to June 2017. Two groups were classified, conventional and modified group, according to the operation applications whether with the help of suspension technique introduced from the First People's Hospital of Ziyang. Perioperative data, complications and follow-up data were collected and analyzed retrospectively.

Results

All surgeries were successfully performed laparoscopically, no conversion to open surgery. Operative time, especially anastomosis time and visual pain score (VPS) on the first postoperative day was significantly shorter in modified group compared with conventional laparoscopic group (P<0.05), there was no difference of estimated blood loss, postoperative hospital stay and mortality rate between the two groups (P>0.05).

Conclusion

Modified suspension anastomosis technique for laparoscopic pyeloplasty is safe and effective, the approach can reduce operative time, shorter learn curves and it's especially suitable for beginners to grasp the sophisticated surgery.

Key words: Laparoscopic, Pyeloplasty, Uretero-pelvic junction obstruction, Learning curve, Suspension

Yuanyi Wen, Yong Wang, Xin Ma, Cheng Hu. Modified anastomosis for the improvement of learning curve in retroperitoneal laparoscopic dismembered pyeloplasty[J]. Chinese Journal of Endourology(Electronic Edition), 2018, 12(04): 244-247.

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URL: https://zhqjmnmwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-3253.2018.04.008

https://zhqjmnmwkzz.cma-cmc.com.cn/EN/Y2018/V12/I04/244

Figures/Tables 3

References 10

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组别	例数	性别（例）		年龄（岁，±s）	侧别（例）		合并肾结石（例）	输尿管高位开口（例）	合并异位血管（例）	肾积水（例）
组别	例数	男	女	年龄（岁，±s）	左	右	合并肾结石（例）	输尿管高位开口（例）	合并异位血管（例）	中度	重度
传统组	14	6	8	18±900	5	9	2	5	3	9	5
改良组	19	12	7	17±11	10	9	1	9	7	13	6
统计值	-	-		t=0.260	-		-	-	-	-
P值	-	0.304		.0.749	0.482		0.375	0.723	0.335	0.804

组别	例数	性别（例）		年龄（岁，±s）	侧别（例）		合并肾结石（例）	输尿管高位开口（例）	合并异位血管（例）	肾积水（例）
组别	例数	男	女	年龄（岁，±s）	左	右	合并肾结石（例）	输尿管高位开口（例）	合并异位血管（例）	中度	重度
传统组	14	6	8	18±900	5	9	2	5	3	9	5
改良组	19	12	7	17±11	10	9	1	9	7	13	6
统计值	-	-		t=0.260	-		-	-	-	-
P值	-	0.304		.0.749	0.482		0.375	0.723	0.335	0.804

组别	例数	手术时间（min）	肾游离时间（min）	肾吻合时间（min）	出血量（ml）	术后住院时间（d）	术后视觉疼痛评分		并发症（例）		术后肾积水程度（例）
组别	例数	手术时间（min）	肾游离时间（min）	肾吻合时间（min）	出血量（ml）	术后住院时间（d）	第1天	第7天	尿瘘	发热	轻度	中度
传统组	14	269±56	59±10	141±2	65±43	8.2±1.8	5.6±1.5	2.7±1.2	2	2	12	2
改良组	19	205±50	53±9	118±27	60±37	8.5±1.8	6.9±1.8	2.3±1.2	0	1	15	4
统计值		t=3.75	t=1.86	t=2.82	0.34	-0.50	-2.36	1.09	-	-	-
P值		0.001	0.069	0.009	0.737	0.624	0.025	0.283	0.058	0.375	0.615

组别	例数	手术时间（min）	肾游离时间（min）	肾吻合时间（min）	出血量（ml）	术后住院时间（d）	术后视觉疼痛评分		并发症（例）		术后肾积水程度（例）
组别	例数	手术时间（min）	肾游离时间（min）	肾吻合时间（min）	出血量（ml）	术后住院时间（d）	第1天	第7天	尿瘘	发热	轻度	中度
传统组	14	269±56	59±10	141±2	65±43	8.2±1.8	5.6±1.5	2.7±1.2	2	2	12	2
改良组	19	205±50	53±9	118±27	60±37	8.5±1.8	6.9±1.8	2.3±1.2	0	1	15	4
统计值		t=3.75	t=1.86	t=2.82	0.34	-0.50	-2.36	1.09	-	-	-
P值		0.001	0.069	0.009	0.737	0.624	0.025	0.283	0.058	0.375	0.615

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