Evolution in the treatment of the ureteropelvic junction obstruction syndrome. Laparoscopic versus open pyeloplasty

INTRODUCTION The treatment of ureteropelvic junction has evolved considerably over the past 20 years, resulting in new surgical techniques, but traditional open surgery remains the gold standard treatment. Currently, less invasive techniques are used for the treatment of ureteropelvic junction obstruction. The purpose of our study is to compare the surgical and functional results between laparoscopic and open pyeloplasty performed at our department during the last 12 years. MATERIAL AND METHODS This is a retrospective review of 92 cases performed in a period of 12 years. Two groups were compared: 30 patients were treated with open surgery (OP) and 62 with a laparoscopic approach (LP). Demographics, clinical presentation, functionality of the affected kidney, presence of polar vessels, kidney stones, hospital stay, complications and functional results were statistically analyzed. RESULTS The mean age was 42 years. The most common clinical presentation was kidney or ureteral pain: 60% (OP) vs. 52% (LP). The right side was affected in 59%; presence of crossing vessels was 47% (OP) vs. 58% (LP); presence of kidney stones was 20% (OP) vs. 19% (LP), with an average hospital stay of 5.86 days (OP) vs. 3.36 days (LP) p <0.05. Post-operative complications were observed in 3 (OP) vs. 5 (LP) patients, with a success rate comparable between groups. CONCLUSIONS In our department, we recommend LP as the standard treatment for ureteropelvic junction obstruction because of the equal success rate compared to OP and the benefits of a minimally invasive surgery.