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Category: Volume 05 Issue 08 August 2017
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Title: A Comparative study between Retroperitoneoscopic and open Dismembered Pyeloplasty in the Management of Ureteropelvic Junction Obstruction

Authors: Venugopal G, Manu M K, Vasantharaja R, Subeesh P, Priyabrata Das, Libu G K

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i8.10

Abstract

Objectives: To evaluate Retroperitoneoscopic dismembered Pyeloplasty (RDP) for Ureteropelvic junction obstruction (UPJO) and compare with Open dismembered Pyeloplasty (ODP) in terms of perioperative outcomes and success rate.

Materials and Methods: We analysed perioperative outcomes and success rates among the 150 cases of ODP and 150 cases of RDP performed from June 2011 to December 2016. Perioperative outcomes were Blood Loss, Analgesia Requirement, incidence of Paralytic ileus, incidence of Atelectasis, Convalescence, day of drain removal, operative time, Hospital Stay and Success Rate. Patients were followed up clinically and radiologically with IVP & Renogram on 3rd month and by Renogram on 12th month and yearly thereafter. Association between variables were compared using Student's t test and Chi Square Test for calculating significance.

Results: Analgesic requirement in terms of morphine equalents 34.55 vs 85.10 mg (RDP vs ODP). Mean day of starting oral intake 1.22 vs. 2.09 days (RDP vs ODP). Mean day of ambulation 1.17 vs. 2.09 days (RDP vs ODP). Mean day of drain removal 2.47 vs. 3.11 days (RDP vs ODP). Mean day of discharge 3.43 vs. 7.18 days (RDP vs ODP). Post-op atelectasis was seen in 10% of ODP and 2% in RDP. Mean operative time were 123.79 vs 135.87 minutes (RDP vs ODP) .Success rates were comparable.

Conclusion: Retroperitoneoscopic Dismembered Pyeloplasty compared to Open Dismembered Pyeloplasty has the advantage of shorter hospital stay, reduced analgesia requirement, reduced incidence of atelectasis, early convalescence and equal success rate proving to be the Gold Standard procedure in management of UPJO.        

Keywords: Retroperitoneoscopy, Pyeloplasty, Ureteropelvic junction obstruction.

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Corresponding Author

Manu M K

Additional Professor, Dept of Urology, Trivandrum Medical College, Trivandrum, Kerala- 695011 India

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