Pyeloplasty in Children: Perioperative Results and Long-term Outcomes of Robotic-assisted Laparoscopic Surgery Compared to Open Surgery

Overview

Journal Pediatr Surg Int

Specialties General Surgery
Pediatrics

Date 2016 Feb 3

PMID 26833312

Citations 15

Authors

Martin Salo

Tania Sjoberg Altemani

Magnus Anderberg

Affiliations

Soon will be listed here.

Abstract

Background: A few studies have compared robotic-assisted laparoscopic pyeloplasty (RALP) with open pyeloplasty (OP) in children, but no previous study includes a long-term follow-up of renal function and hydronephrosis in combination with a thorough prospective follow-up of the RALP patients of at least 2 years.

Objective: To analyze perioperative results and long-term outcome of children with obstruction of the ureteropelvic junction, operated on with RALP compared to OP.

Patients And Methods: Children ≤15 years operated on with RALP or OP from 2000 through 2013 were reviewed. Patient demographics, perioperative data, postoperative complications, and long-term outcome were evaluated. The outcome was based on pre- and postoperative examination of renal function, hydronephrosis and flank pain.

Results: 129 pyeloplasties (84 OP, 39 RALP, 6 reoperations) on 123 patients were included. RALP had significantly longer operative time and shorter postoperative hospital stay, compared to OP. No difference was found in postoperative need of morphine or complication rates. Mean follow-up for RALP with ultrasound was 29 and 25 months with renal scan, compared to 34 and 28 months, respectively, for OP. The success rate for flank pain was 96 and 94 %, for hydronephrosis 93 and 95 %, and renal function 94 and 92 %, for RALP and OP, respectively.

Conclusions: RALP is a safe method, with advantages compared to OP, and with the same success rate. This study supports the use of RALP in children.

Citing Articles

Analysis of outcomes of robot-assisted laparoscopic pyeloplasty in children from a tertiary pediatric center in South India.

Vidhya T, Rajiv P, Sripathi V Front Pediatr. 2024; 12:1376644.

PMID: 38989271 PMC: 11233726. DOI: 10.3389/fped.2024.1376644.

The application of artificial technology in pediatric pyeloplasty the efficacy analysis of robotic-assisted laparoscopic pyeloplasty in the treatment of ureteropelvic junction obstruction.

Hu Z, Chen S, Wang Z, Xu D, Zhang X, Lin Y Front Pediatr. 2023; 11:1209359.

PMID: 37780043 PMC: 10540863. DOI: 10.3389/fped.2023.1209359.

The efficacy of robotic-assisted laparoscopic pyeloplasty for pediatric ureteropelvic junction obstruction: a systematic review and meta-analysis.

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

PMID: 37673951 DOI: 10.1007/s00383-023-05541-8.

Robot-assisted Laparoscopic Pyeloplasty: Experience of a Single Pediatric Institution, Including Long-term and Safety Outcomes.

Lai A, Shannon R, Rosoklija I, Johnson E, Gong E, Chu D Urology. 2023; 176:167-170.

PMID: 37004846 PMC: 10330237. DOI: 10.1016/j.urology.2022.12.070.

Robotic-assisted pyeloplasty in children: a systematic review of the literature.

Esposito C, Cerulo M, Lepore B, Coppola V, DAuria D, Esposito G J Robot Surg. 2023; 17(4):1239-1246.

PMID: 36913057 PMC: 10374693. DOI: 10.1007/s11701-023-01559-1.

References

Morin L, Cendron M, Crombleholme T, Garmel S, Klauber G, DAlton M . Minimal hydronephrosis in the fetus: clinical significance and implications for management. J Urol. 1996; 155(6):2047-9. DOI: 10.1016/s0022-5347(01)66102-0. View

Capello S, Kogan B, Giorgi Jr L, Kaufman Jr R . Prenatal ultrasound has led to earlier detection and repair of ureteropelvic junction obstruction. J Urol. 2005; 174(4 Pt 1):1425-8. DOI: 10.1097/01.ju.0000173130.86238.39. View

Rowe C, Pierce M, Tecci K, Houck C, Mandell J, Retik A . A comparative direct cost analysis of pediatric urologic robot-assisted laparoscopic surgery versus open surgery: could robot-assisted surgery be less expensive?. J Endourol. 2012; 26(7):871-7. DOI: 10.1089/end.2011.0584. View

Bansal D, Cost N, DeFoor Jr W, Reddy P, Minevich E, VanderBrink B . Infant robotic pyeloplasty: comparison with an open cohort. J Pediatr Urol. 2013; 10(2):380-5. DOI: 10.1016/j.jpurol.2013.10.016. View

Lindgren B, Hagerty J, Meyer T, Cheng E . Robot-assisted laparoscopic reoperative repair for failed pyeloplasty in children: a safe and highly effective treatment option. J Urol. 2012; 188(3):932-7. DOI: 10.1016/j.juro.2012.04.118. View

Casale P . Robotic pyeloplasty in the pediatric population. Curr Opin Urol. 2008; 19(1):97-101. DOI: 10.1097/MOU.0b013e32831ac6e8. 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

Calisti A, Perrotta M, Oriolo L, Patti G, Marrocco G, Miele V . Functional outcome after pyeloplasty in children: impact of the cause of obstruction and of the mode of presentation. Eur Urol. 2003; 43(6):706-10. DOI: 10.1016/s0302-2838(03)00144-1. View

Yee D, Shanberg A, Duel B, Rodriguez E, Eichel L, Rajpoot D . Initial comparison of robotic-assisted laparoscopic versus open pyeloplasty in children. Urology. 2006; 67(3):599-602. DOI: 10.1016/j.urology.2005.09.021. View

10.

Peters C, Schlussel R, Retik A . Pediatric laparoscopic dismembered pyeloplasty. J Urol. 1995; 153(6):1962-5. View

11.

Casale P . Robotic pediatric urology. Expert Rev Med Devices. 2007; 5(1):59-64. DOI: 10.1586/17434440.5.1.59. View

12.

Shive M, Baskin L, Harris C, Bonham M, MacKenzie J . Ureteral fibroepithelial polyp causing urinary obstruction. J Radiol Case Rep. 2013; 6(7):23-8. PMC: 3558047. DOI: 10.3941/jrcr.v6i7.1076. View

13.

SCHUESSLER W, Grune M, Tecuanhuey L, Preminger G . Laparoscopic dismembered pyeloplasty. J Urol. 1993; 150(6):1795-9. DOI: 10.1016/s0022-5347(17)35898-6. View

14.

Kutikov A, Nguyen M, Guzzo T, Canter D, Casale P . Robot assisted pyeloplasty in the infant-lessons learned. J Urol. 2006; 176(5):2237-9. DOI: 10.1016/j.juro.2006.07.059. View

15.

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

16.

Van Batavia J, Casale P . Robotic surgery in pediatric urology. Curr Urol Rep. 2014; 15(5):402. DOI: 10.1007/s11934-014-0402-9. View

17.

Palese M, Munver R, Phillips C, Dinlenc C, Stifelman M, DelPizzo J . Robot-assisted laparoscopic dismembered pyeloplasty. JSLS. 2005; 9(3):252-7. PMC: 3015619. View

18.

Lee R, Retik A, Borer J, Peters C . Pediatric robot assisted laparoscopic dismembered pyeloplasty: comparison with a cohort of open surgery. J Urol. 2006; 175(2):683-7. DOI: 10.1016/S0022-5347(05)00183-7. View

19.

Barbosa J, Kowal A, Onal B, Gouveia E, Walters M, Newcomer J . Comparative evaluation of the resolution of hydronephrosis in children who underwent open and robotic-assisted laparoscopic pyeloplasty. J Pediatr Urol. 2012; 9(2):199-205. DOI: 10.1016/j.jpurol.2012.02.002. View

20.

Sorensen M, Delostrinos C, Johnson M, Grady R, Lendvay T . Comparison of the learning curve and outcomes of robotic assisted pediatric pyeloplasty. J Urol. 2011; 185(6 Suppl):2517-22. DOI: 10.1016/j.juro.2011.01.021. View