Vol. 6, Issue 1, Part B (2024)

Background: Pelviureteric junction obstruction causes hydronephrosis and progressive renal impairment if left untreated. Open pyeloplasty is commonly practiced to correct pelviureteric junction obstruction. Laparoscopic pyeloplasty is becoming popular worldwide maintaining acceptable outcome same as open procedure but less morbidity. 
Aim of the study: This study was aimed to compare the outcomes of laparoscopic versus open pyeloplasty in the treatment of pelviureteric junction obstruction. 
Methods: This prospective quasi experimental study was conducted in the Department of Urology, Sir Salimullah Medical College Mitford Hospital, Shaheed Suhrawardy Medical College Hospital and Dhaka Central International Medical College Hospital in Dhaka during the period of July, 2018 to December, 2019. Total forty patients were included for the study as per predefined inclusion and exclusion criteria and were allocated into two groups purposively. All the odd numbered cases were allocated into Group - A for open pyeloplasty and the even numbered cases were allocated into Group - B for laparoscopic pyeloplasty. 
Results: In Group-B (Laparoscopic pyeloplasty) trend of visual analogue scale of pain was significantly shorter than group-A (Open pyeloplasty) at 24 hour and at 72 hours was 3.4±(0.94) and 2.1±(0.21) versus 5.6±(1.13) and 4.9±(1.11) respectively (p<0.05). However, surgical site infection (20%) was more evident in Group- A (Open pyeloplasty) whereas anastomotic leakage (20%) was predominantly occurred in Group-B. (Laparoscopic pyeloplasty). Duration of hospital staying was 7(±2.04) days and 3(±0.08) days in Group-A (Open pyeloplasty) and Group-B (Laparoscopic pyeloplasty) respectively (p=0.0001) which is clearly shorter in Group-B. Split renal function of the respective kidney significantly improved in both the laparoscopic and open pyeloplasty group (p<.05) after surgery. 
Conclusion: Laparoscopic pyeloplasty is a better procedure for the management of PUJ obstruction due to minimal morbidity and shorter hospital stay compared to open approach.