The Application Of Laparoscopic Dismembered Pyeloplasty And Renal Placation For Giant Hydronephrosis Caused By UPJO

Objective:Hydronephrosis is a normal disease in Urology which is caused by obstructive affections and classified light, midrange, serious and giant hydronephrosis in degree.Giant hydronephrosi is definitied as pelvic volume>1000mL(or exceed urine volume of 24h in children). Most hydronephrosis is caused by UPJO in clinic and treated by pyeloplasty as the "Golden standard".Now we introduce a method, laparoscopic dismembered pyeloplasty and renal placation for giant hydronephrosis caused by UPJO, and compare with the "Golden standard"Methods:The clinical data of 36 cases of giant hydronephrosis caused by UPJO were from June,2006 to January,2010 retrospectively. Laparoscopic surgery was performed in all the 36 cases; in group A 20 patients received laparoscopic dismembered pyeloplasty and renal placation while in group B 16 patients received simple laparoscopic pyeloplasty.We collect clinical data to analyze the difference between the 2 groups, including the average volume of kidney, average GFR, average operative time, average blood loss, postoperative recovery and follow-up of 3months,5 months and 12 months.Results:(1) All the 36 cases in 2 groups were performed with laparoscopic surgery; (2) There was no signification difference of baseline characteristics beteen the 2 groups;(3) The average operation was 149.75±14.19minutes in Group A and 130.41±12.71minutes in Group B;(4) There was no signification difference of blood loss, hospitali-zation time;(5) There was signification difference of the 2 groups, in the recovery of the morphous and function of the kidney.Conclusions:1. Both of simple laparoscopic pyeloplasty and laparoscopic dismembered pyeloplasty and renal placation are good choices for hydronephrosis caused by UPJO;2. For the recovery of the morphous and function of the kidney, laparoscopic dismembered pyeloplasty and renal placation is much better than simple laparoscopic pyeloplasty.3.The size and morphous of the kidney become almost normal after the theatment of laparoscopic dismembered pyeloplasty and renal placation, so there is better draining of urine for less infection.