Retrospective And Comparative Analysis On Transumbilical Laparoendoscopic Single-Site Three-Port Pyeloplasty And Conventional Laparoscopic Pyeloplasty

Objective: Comparatively analyzes the differentiation of the case information, clinical indices of perioperative period and follow-up in LESS-P and CTL-P, discusses the feasibility of LESS-P and evaluates the clinical application.Methods: Retrospective analysis of 84 cases carried out by the same surgeon of continuous ureteropelvic junction obstruction(UPJO) cases from August 2013 to July 2015, including two different laparoendoscopic pyeloplasty procedures by the same operator. On stages using Conventional Laparoscopic Pyeloplasty CTL-P(n=36) and Transumbilical Laparoendoscopic Single-Site Three-Port Pyeloplasty LESS-P(n=48). 63 patients were male and 21 were female. 61 cases had obstruction on the left side 18 on the right side and bilateral in 5 cases. Mean age is 4.55±3.68 years. We collected the general data of patients and the operation time, intraoperative blood loss, drainage tube indwelling time, perioperative complications, pelvis separation in B-ultrasound and other aspects of the data, and the results were compared between two groups. All data were checked up by normality test and test of homogeneity of variance, and then were analyzed by t test and Chi square test. There were significant differences in P<0.05.Results: All operations of two groups were performed successfully. None of group experienced conversion to open surgery and no additional port or incision besides the umbilicus was needed. There was no statistically significant difference in age, gender composition, affected side, operative route, estimated intraoperative blood loss, time of resumption to a regular diet, postoperative hospital stay, time of indwelling drainage tube, anastomotic leakage, recurrent urinary tract infection and complications between two groups(P> 0.05). There was statistically significant difference in the mean operation time and pelvis separation in B-ultrasound. The mean operation time of LESS-P group was longer than CTL-P group, the differences of two groups were statistically significant(P<0.05). The preoperative pelvis separation of two groups was no significant difference(P>0.05), while the postoperative data was statistically significant difference(P<0.05). The postoperative pelvis separation in B-ultrasound was both decreased compared to those in two groups preoperatively(P <0.05).Conclusion: The effect of LESS-P and CTL-P in children with UPJO is both safe and feasible. The operation time of LESS-P was longer than that of CTL-P. After the learning curve, there was no difference in the operation time. LESS-P presents a better cosmetic outcome than CTL-P, and it has lower requirements for equipment, easier to replicate and promote. Therefore, it is the ideal surgical procedure of UPJO in children.