title: Evolution in the treatment of the ureteropelvic junction obstruction syndrome. Laparoscopic versus open pyeloplasty.
abstract: BACKGROUND
  The treatment of ureteropelvic junction has evolved considerably over the past 20 years, resulting in new surgical techniques, but traditional open surgery remains the gold standard treatment. Currently, less invasive techniques are used for the treatment of ureteropelvic junction obstruction. The purpose of our study is to compare the surgical and functional results between laparoscopic and open pyeloplasty performed at our department during the last 12 years.
  
  
  METHODS
  This is a retrospective review of 92 cases performed in a period of 12 years. Two groups were compared: 30 patients were treated with open surgery (OP) and 62 with a laparoscopic approach (LP). Demographics, clinical presentation, functionality of the affected kidney, presence of polar vessels, kidney stones, hospital stay, complications and functional results were statistically analyzed.
  
  
  RESULTS
  The mean age was 42 years. The most common clinical presentation was kidney or ureteral pain: 60% (OP) vs. 52% (LP). The right side was affected in 59%; presence of crossing vessels was 47% (OP) vs. 58% (LP); presence of kidney stones was 20% (OP) vs. 19% (LP), with an average hospital stay of 5.86 days (OP) vs. 3.36 days (LP) p <0.05. Post-operative complications were observed in 3 (OP) vs. 5 (LP) patients, with a success rate comparable between groups.
  
  
  CONCLUSIONS
  In our department, we recommend LP as the standard treatment for ureteropelvic junction obstruction because of the equal success rate compared to OP and the benefits of a minimally invasive surgery.
authors.affiliation: Department of Urology, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Juan Gómez
authors.initials: JG
authors.lastname: Rivas
authors.affiliation: Department of Urology, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Sergio Alonso Y
authors.initials: SA
authors.lastname: Gregorio
authors.affiliation: Department of Urology, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Leslie Cuello
authors.initials: LC
authors.lastname: Sánchez
authors.affiliation: Department of Urology, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Pamela Fontana
authors.initials: PF
authors.lastname: Portella
authors.affiliation: Department of Urology, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Ángel Tabernero
authors.initials: ÁT
authors.lastname: Gómez
authors.affiliation: Department of Urology, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Jesús Cisneros
authors.initials: JC
authors.lastname: Ledo
authors.affiliation: Department of Urology, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Jesús Díez
authors.initials: JD
authors.lastname: Sebastián
authors.affiliation: Department of Urology, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Jesús Javier de la Peña
authors.initials: JJ
authors.lastname: Barthel
keywords: laparoscopic pyeloplasty; open pyeloplasty; ureteropelvic junction obstruction