An Updated Meta-analysis of Laparoscopic Versus Open Pyeloplasty for Ureteropelvic Junction Obstruction in Children

Overview

Journal Int J Clin Exp Med

Specialty General Medicine

Date 2015 Jul 2

PMID 26131065

Citations 19

Authors

Yidong Huang

Yang Wu

Wei Shan

Li Zeng

Lugang Huang

Affiliations

Soon will be listed here.

Abstract

Purpose: To further explore the feasibility and safety of laparoscopic pyeloplasty (LP) in children with ureteropelvic junction obstruction compared with open pyeloplasty (OP).

Methods: PUBMED, Web of science and Cochrane library were searched until Oct. 2014 to find eligible studies. WMD, OR, RD and their 95% CIs were used to estimate the difference. Baseline such as age, gender and crossing vessel, perioperative outcomes such as length of stay, operative time, overall complications, and success rate were compared. All the meta-analyses were performed in Revman 5.2.

Results: 15 comparative studies and one RCT were eligible and included in the meta-analysis. Compared with OP, LP groups might be associated with shorted length of hospital stay (WMD: -1.92, 95% CI: -2.45--1.39), reduced complications (OR: 0.71, 95% CI: 0.49-1.01) and equal success rate (RD: 0.01, 95% CI: -0.02-0.04), but prolonged operative time (WMD: 48.64, 95% CI: 31.16-66.12).

Conclusion: Our findings supported that laparoscopic pyeloplasty is feasibility and safety in the treatment of UPJ obstruction in children, especially in high-volume centers with experienced experts. Considering the select bias and recall bias, more RCTs are required to further explore the efficiencies of LP.

Citing Articles

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Efficacy of laparoscopic pyeloplasty for pediatric hydronephrosis caused by symptomatic versus asymptomatic endogenous ureteropelvic junction obstruction: a retrospective analysis.

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Sun M, Yu C, Zhao J, Liu M, Liu Y, Han R Pediatr Surg Int. 2023; 39(1):265.

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Does prophylactic antibiotics post pediatric pyeloplasty reduce the incidence of febrile UTIs?.

Sheth K, Puttmann K, Nichols P, King J, Zhu H, Ryan S BMC Urol. 2023; 23(1):133.

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Cascini V, Lauriti G, Di Renzo D, Miscia M, Lisi G Front Pediatr. 2022; 10:1052440.

PMID: 36507128 PMC: 9727311. DOI: 10.3389/fped.2022.1052440.

References

Singh H, Ganpule A, Malhotra V, Manohar T, Muthu V, Desai M . Transperitoneal laparoscopic pyeloplasty in children. J Endourol. 2008; 21(12):1461-6. DOI: 10.1089/end.2007.0023. View

Vemulakonda V, Cowan C, Lendvay T, Joyner B, Grady R . Surgical management of congenital ureteropelvic junction obstruction: a Pediatric Health Information System database study. J Urol. 2008; 180(4 Suppl):1689-92. DOI: 10.1016/j.juro.2008.03.096. View

Penn H, Gatti J, Hoestje S, DeMarco R, Snyder C, Murphy J . Laparoscopic versus open pyeloplasty in children: preliminary report of a prospective randomized trial. J Urol. 2010; 184(2):690-5. DOI: 10.1016/j.juro.2010.03.062. View

Lam P, Wong C, Mulholland T, Campbell J, Kropp B . Pediatric laparoscopic pyeloplasty: 4-year experience. J Endourol. 2008; 21(12):1467-71. DOI: 10.1089/end.2007.9876. View

Wang L, Qin W, Tian F, Zhang G, Yuan J, Wang H . Cytokine responses following laparoscopic or open pyeloplasty in children. Surg Endosc. 2008; 23(3):544-9. DOI: 10.1007/s00464-008-9859-2. View

Wang X, Zhang Z, Peng N, Liu C . Retroperitoneal laparoscopic versus open dismembered pyeloplasty for ureteropelvic junction obstruction. J Xray Sci Technol. 2013; 21(3):429-39. DOI: 10.3233/XST-130394. View

Olsen L, Rawashdeh Y, Jorgensen T . Pediatric robot assisted retroperitoneoscopic pyeloplasty: a 5-year experience. J Urol. 2007; 178(5):2137-41. DOI: 10.1016/j.juro.2007.07.057. View

Valla J, Breaud J, Griffin S, Sautot-Vial N, Beretta F, Guana R . Retroperitoneoscopic vs open dismembered pyeloplasty for ureteropelvic junction obstruction in children. J Pediatr Urol. 2009; 5(5):368-73. DOI: 10.1016/j.jpurol.2009.02.202. View

van der Toorn F, van den Hoek J, Wolffenbuttel K, Scheepe J . Laparoscopic transperitoneal pyeloplasty in children from age of 3 years: our clinical outcomes compared with open surgery. J Pediatr Urol. 2012; 9(2):161-8. DOI: 10.1016/j.jpurol.2012.01.007. View

10.

Varda B, Johnson E, Clark C, Chung B, Nelson C, Chang S . National trends of perioperative outcomes and costs for open, laparoscopic and robotic pediatric pyeloplasty. J Urol. 2014; 191(4):1090-5. PMC: 4154938. DOI: 10.1016/j.juro.2013.10.077. View

11.

Liu D, Ellimoottil C, Flum A, Casey J, Gong E . Contemporary national comparison of open, laparoscopic, and robotic-assisted laparoscopic pediatric pyeloplasty. J Pediatr Urol. 2014; 10(4):610-5. DOI: 10.1016/j.jpurol.2014.06.010. View

12.

Stroup D, Berlin J, Morton S, Olkin I, Williamson G, Rennie D . Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA. 2000; 283(15):2008-12. DOI: 10.1001/jama.283.15.2008. View

13.

Herndon C, Herbst K, Smith C . The transition from open to laparoscopic pediatric pyeloplasty: a single-surgeon experience. J Pediatr Urol. 2012; 9(4):409-14. DOI: 10.1016/j.jpurol.2012.06.009. View

14.

Ravish I, Nerli R, Reddy M, Amarkhed S . Laparoscopic pyeloplasty compared with open pyeloplasty in children. J Endourol. 2007; 21(8):897-902. DOI: 10.1089/end.2006.0411. View

15.

Bonnard A, Fouquet V, Carricaburu E, Aigrain Y, El-Ghoneimi A . Retroperitoneal laparoscopic versus open pyeloplasty in children. J Urol. 2005; 173(5):1710-3. DOI: 10.1097/01.ju.0000154169.74458.32. View

16.

Yu J, Wu Z, Xu Y, Li Z, Wang J, Qi F . Retroperitoneal laparoscopic dismembered pyeloplasty with a novel technique of JJ stenting in children. BJU Int. 2011; 108(5):756-9. DOI: 10.1111/j.1464-410X.2011.10001.x. View

17.

Mei H, Pu J, Yang C, Zhang H, Zheng L, Tong Q . Laparoscopic versus open pyeloplasty for ureteropelvic junction obstruction in children: a systematic review and meta-analysis. J Endourol. 2011; 25(5):727-36. DOI: 10.1089/end.2010.0544. View

18.

Sedlacek J, Kocvara R, Molcan J, Dite Z, Dvoracek J . Transmesocolic laparoscopic pyeloplasty in children: a standard approach for the left-side repair. J Pediatr Urol. 2009; 6(2):171-7. DOI: 10.1016/j.jpurol.2009.06.010. View

19.

Knoedler J, Han L, Granberg C, Kramer S, Chow G, Gettman M . Population-based comparison of laparoscopic and open pyeloplasty in paediatric pelvi-ureteric junction obstruction. BJU Int. 2013; 111(7):1141-7. DOI: 10.1111/bju.12039. View

20.

Garcia-Aparicio L, Blazquez-Gomez E, Martin O, Manzanares A, Garcia-Smith N, Bejarano M . Anderson-hynes pyeloplasty in patients less than 12 months old. Is the laparoscopic approach safe and feasible?. J Endourol. 2014; 28(8):906-8. DOI: 10.1089/end.2013.0704. View