Comparison of holmium laser incision and internal drainage under flexible ureteroscope and retroperitoneal laparoscopic decompression to stress response in patients with parapelvic cyst

Abstract

Objective To compare the effects of ureteroscopic holmium laser incision and internal drainage surgery with posterior laparoscopic decompression on the stress response of patients with parapelvic cyst. Methods A total of 42 patients with parapelvic cyst treated in our hospital from January 2015 to January 2018 were selected for a prospective study, and were randomly divided into 2 groups, with 21 cases in each group. The control group was treated with retroperitoneal laparoscopic decompression, while the observation group underwent ureteroscopic holmium laser incision and internal drainage surgery. The general conditions of surgery, oxidative stress indicators, stress hormone indicators and complications were compared between the 2 groups. Results As compared with the control group, the operation time, anal exhaust time, postoperative hospital stay were significantly shortened, and intraoperative blood loss was reduced in the observation group (P 0.05). However, after operation, MDA and GSSG were significantly decreased while SOD and GSH increased in both groups, and the observation group had higher MDA and GSSG, but lower SOD and GSH when compared with the control group (P < 0.05). Likewise, preoperative stress hormone indicators of cortisol (Cor), noradrenaline (NE), angiotensin Ⅱ (AngⅡ) and dopamine (DA) did not differ from the 2 groups, but they were all significantly elevated in both groups after operation, and the levels in the observation group were obviously lower than those in the control group (P < 0.05). In addition, there were 2 cases of postoperative complications (1 incision infection and 1 increased temperature) in the control group, and 1 case (increased temperature) in the observation group, showing no significant difference. Conclusion Holmium laser incision and internal drainage under flexible ureteroscope has less effect on oxidative stress and hormone stress and does not increase the incidence of complications in patients with parapelvic cyst.

Keywords

• ureteroscopic holmium laser incision and internal drainage
• retroperitoneal laparoscopic decompression
• parapelvic cyst
• therapeutic effect