신우요관이행부협착에 대한 최소 침습적인 수술의 결과 비교: 내신우절개술, Acucise 내신우절개술, 복강경신우성형술
A Comparison of Minimally Invasive Surgical Techniques for Ureteropelvic Junction Obstructions: Endopyelotomy, Acucise Endopyelotomy, and Laparoscopic Pyeloplasty
한동엽, 박광성, 서일영, 임정식,
소속 상세정보
한동엽 ( Han Dong-Youp )
원광대학교 의과대학 비뇨기과학교실
박광성 ( Park Kwang-Sung )
전남대학교 의과대학 비뇨기과학교실
서일영 ( Seo Ill-Young )
원광대학교 의과대학 비뇨기과학교실
임정식 ( Rim Joung-Sik )
원광대학교 의과대학 비뇨기과학교실
KMID : 0358320080490070592
Abstract
Purpose:The aim of this study was to compare the efficacy and outcomes of endopyelotomy, Acucise endopyelotomy, and laparoscopic pyeloplasty for patients with ureteropelvic junction obstructions.
Material and Methods :We studied 45 patients with ureteropelvic junction obstructions who underwent minimally invasive surgeries between January 2001 and April 2007. Patients were divided into three groups according to operative procedure: group I, endopyelotomy(n=17); group II, Acucise endopyelotomy(n=12; and group III, laparoscopic pyeloplasty(n=16).
Results:The mean patient ages in the three groups were 42.7±17.2 years, 48.8±14.1 years, and 49.5±13.6 years for groups I, II, and III, respectively. The mean stricture lengths were 0.99±0.25cm, 0.93±0.10cm, and 1.03±0.38 cm for groups I, II, and III, respectively, and were not significantly different among the groups(p＞0.05). The mean operating time for group II(55.7±25.3 minutes) was shorter than that for group I(131.7±30.5 minutes) and group III(165.2±23.7 minutes)(p＜0.05). The length of hospital stay for group II(4.7±1.6 days) was shorter than that for group I(6.6±1.8 days) and group III(7.4±0.6 days)(p＜0.05). Rates of symptomatic improvement were 58.8%, 66.7%, and 93.8% for groups I, II, and III, respectively. Rates of radiologic improvement were 58.8%, 66.7%, and 93.8% for groups I, II, and III, respectively. There was no significant correlation between success rate and either stricture length or degree of hydronephrosis.
Conclusion:Laparoscopic pyeloplasty had the highest success rate among the minimally invasive surgeries for patients with ureteropelvic junction obstructions. However, when the stricture length is less than 1cm in length, Acucise endopyelotomy may be considered as the first treatment because the associated operating time and hospital stay are short.
키워드
Ureteroscopy;Acucise;Endopyelotomy;Laparoscopy
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