Laparoendoscopic single-site versus conventional transperitoneal laparoscopic pyeloplasty: a prospective randomized...

Area of Science:

• Urology
• Minimally Invasive Surgery
• Surgical Techniques

Background:

• Ureteropelvic junction (UPJ) obstruction is a common congenital anomaly requiring surgical correction.
• Conventional laparoscopic pyeloplasty is a standard minimally invasive approach.
• Laparoendoscopic single-site surgery (LSS) aims to further reduce invasiveness and improve cosmetic outcomes.

Purpose of the Study:

• To compare the efficacy and outcomes of laparoendoscopic single-site pyeloplasty (LSSP) versus conventional laparoscopic pyeloplasty (CLP).
• To evaluate potential benefits of LSSP in terms of recovery, patient satisfaction, and cosmetic results.

Main Methods:

• A prospective randomized study comparing LSSP (n=19) and CLP (n=20) for UPJ obstruction.
• Statistical analysis using Mann-Whitney U-test and chi-squared test (P<0.05 considered significant).
• Outcomes assessed included operative time, blood loss, transfusion rates, hospitalization, return to normal activities, complications, cosmetic results, patient satisfaction, and success rates.

Main Results:

• No significant differences in blood loss, transfusion rates, or hospitalization time between LSSP and CLP.
• LSSP demonstrated a significantly shorter time to return to normal activities (P=0.01).
• Operative time was longer for LSSP (P=0.001), but cosmetic results, patient satisfaction, visual analog scale scores, and postoperative analgesic use were significantly better with LSSP. Success rates were 95% in both groups.

Conclusions:

• Laparoscopic single-site pyeloplasty provides faster recovery and enhanced patient satisfaction compared to conventional laparoscopic pyeloplasty.
• LSSP is a viable and promising alternative for minimally invasive management of UPJ obstruction, offering superior cosmetic outcomes and patient experience.