Small-incision access retroperitoneoscopic technique (SMART) pyeloplasty in adult patients: comparison of cosmetic and post-operative pain outcomes in a matched-pair analysis with standard retroperitoneoscopy: preliminary report

ObjectivesTo present small-incision access retroperitoneoscopic technique pyeloplasty (SMARTp), a novel mini-laparoscopic approach for management of uretero-pelvic junction obstruction (UPJO) in adults including comparison with the standard retroperitoneoscopic technique (SRTp).MethodsIn a non-rando...

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Hauptverfasser: Pini, Giovannalberto (VerfasserIn) , Gözen, Ali Serdar (VerfasserIn) , Schulze, Michael (VerfasserIn) , Fiedler, Marcel (VerfasserIn) , Klein, Jan (VerfasserIn) , Rassweiler, Jens (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 2011
In: World journal of urology
Year: 2012, Jahrgang: 30, Heft: 5, Pages: 605-611
ISSN:1433-8726
DOI:10.1007/s00345-011-0740-x
Online-Zugang:Verlag, Volltext: http://dx.doi.org/10.1007/s00345-011-0740-x
Verlag, Volltext: https://doi.org/10.1007/s00345-011-0740-x
Volltext
Verfasserangaben:Giovannalberto Pini, Ali Serdar Goezen, Michael Schulze, Marcel Hruza, Jan Klein, Jens Jochen Rassweiler

MARC

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245 1 0 |a Small-incision access retroperitoneoscopic technique (SMART) pyeloplasty in adult patients  |b comparison of cosmetic and post-operative pain outcomes in a matched-pair analysis with standard retroperitoneoscopy: preliminary report  |c Giovannalberto Pini, Ali Serdar Goezen, Michael Schulze, Marcel Hruza, Jan Klein, Jens Jochen Rassweiler 
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520 |a ObjectivesTo present small-incision access retroperitoneoscopic technique pyeloplasty (SMARTp), a novel mini-laparoscopic approach for management of uretero-pelvic junction obstruction (UPJO) in adults including comparison with the standard retroperitoneoscopic technique (SRTp).MethodsIn a non-randomised study, we matched 12 adult patients treated from August to November 2010 by SMARTp with 12 patients treated with SRTp from January to November 2010. Mini-laparoscopic retroperitoneal space was created with a home-made 6-mm balloon trocar. One 6-mm (for 5-mm 30° telescope) and two 3.5-mm trocars (for 3-mm working instrument) were used. SRTp was performed with 11- and 6-mm trocar. Primary endpoints included evaluation of cosmetic appearance and post-operative pain evaluated respectively by the patient and observer scar assessment scale (POSAS) and analogue visual scale (VAS). Secondary endpoints were comparison between operative and functional parameters.ResultsCosmetic cumulative results were statistically significant in favour of SMARTp (POSAS: 37.9 vs. 52.4; P = 0.002). A better trend has been shown by post-operative pain (first to fourth day VAS), although not statistically significant (4.2 vs. 4.9, P = 0.891). No differences were recorded in terms of operative time, pre- and post-operative Hb difference, DJ-stent removal and resistive index (RI) improvement. The SMARTp group showed a faster drain removal (2.4 vs. 3.4 day, P = 0.004) and discharge (4.5 vs. 5.4 day P = 0.017).ConclusionsPreliminary data support SMARTp as safe procedures in experienced hands, providing better cosmetic results compared to SRTp. Further studies and clinical randomised trial performed in a larger population sample are requested. 
650 4 |a Laparoscopy 
650 4 |a LESS 
650 4 |a Micro-laparoscopy 
650 4 |a Mini-laparoscopy 
650 4 |a Needlescopy 
650 4 |a NOTES 
650 4 |a Patient and observer scar assessment scale 
650 4 |a POSAS 
650 4 |a Pyelo-ureteric junction obstruction 
650 4 |a Pyeloplasty 
650 4 |a Retroperitoneoscopy 
650 4 |a Scar assessment 
650 4 |a SMART 
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