Can laparoendoscopic single site（LESS）pyeloplasty become a standard procedure for ureteropelvic junction obstruction? Comparative analysis of 3 different procedures：open, laparoscopic, and LESS pyeloplasty at a single institution.

Abstract

  Cosmetic results are superior with laparoendoscopic single-site pyeloplasty（LESS-P）than open pyeloplasty（OP）or laparoscopic pyeloplasty（LP）for ureteropelvic junction obstruction（UPJO）. We compared these 3 different procedures of OP, LP, and LESS-P with regard to the success rates and surgical morbidities. Three procedures were conducted by different surgeons：OP was performed by a pediatric urologist（KJ）；LP was performed by a certified urological laparoscopic surgeon（NM）；and LESS-P was performed by a pediatric urologist with certified urological laparoscopic skills（AK）. There were no significant differences among the 3 procedures regarding the success rate, operative time, reoperation rate, rate of complications above Clavien-Dindo G III, analgesia use, or postoperative hospital stay. Although special surgical skills are needed, LESS-P is considered to be an ideal procedure for UPJO because it is associated with more favorable cosmetic results.