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Multicenter Study
. 2022 Nov-Dec;48(6):961-968.
doi: 10.1590/S1677-5538.IBJU.2022.0194.

Multicenter comparative study of open, laparoscopic, and robotic pyeloplasty in the pediatric population for the treatment of ureteropelvic junction obstruction (UPJO)

Sebastian Tobía González  1   2 , Tiago E Rosito  3   4 , Anna Bujons Tur  5 , Javier Ruiz  6 , Rafael Gozalbez  7 , Anabella Maiolo  2 , Patric M Tavares  3   4 , Antonio Rebello Horta Gorgen  3 , Erika Llorens de Kencht  5 , Yesica Quiroz Madarriaga  5 , Santiago Weller  6 , Ignacio Pablo Tobia  1 , Miguel Castellan  7 , Juan Pablo Corbetta  6
Affiliations
Multicenter Study

Multicenter comparative study of open, laparoscopic, and robotic pyeloplasty in the pediatric population for the treatment of ureteropelvic junction obstruction (UPJO)

Sebastian Tobía González et al. Int Braz J Urol. 2022 Nov-Dec.

Abstract

Introduction: Dismembered open pyeloplasty described by Anderson and Hynes is the "gold standard" for the treatment of ureteropelvic junction obstruction. The aim of our study was to compare the results of open (OP) vs laparoscopic (LP) vs robotic (RALP) pyeloplasty.

Material and methods: A multicenter prospective review was conducted of pyeloplasty surgeries performed at five high-volume centers between 2014 and 2018. Demographic data, history of prenatal hydronephrosis, access type, MAG3 renogram and differential renal function, surgery time, length of hospital stay, and complication rate (Clavien-Dindo) were recorded. Access type was compared using the Kruskal-Wallis, Chi-square, or Fisher's exact tests.

Results: A total of 322 patients were included: 62 OP, 86 LP, and 174 RALP. The mean age was 8.13 (r: 1-16) years, with a statistically significant lower age (mean 5 years) in OP (p < 0.001). There were no significant differences in the distribution of the side affected. Operative time was 110.5 min for OP, 140 min for LP, and 179 min for RALP (p < 0.0001). Hospital stay was significantly shorter in the RALP group than in the other groups (p < 0.0001). There were no differences in postoperative complications and reoperations between the three groups.

Conclusions: Minimally invasive surgery for the management of UPJO in children is gaining more acceptance, even in patients younger than 1-year-old. Operative time continues to be significantly shorter in OP than in LP and RALP. Hospital stay was shorter in RALP compared to the other techniques. No differences were found in complication rates, type of complications, and reoperation rate.

Keywords: Laparoscopy; Robotics; Ureteral Obstruction.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1. Comparison of surgical time and hospital stay in open, laparoscopic and robotic pyeloplasty.
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