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Pediatric Surgery International

Published in:

01-06-2016 | Original Article

Pyeloplasty in children: perioperative results and long-term outcomes of robotic-assisted laparoscopic surgery compared to open surgery

Authors: Martin Salö, Tania Sjöberg Altemani, Magnus Anderberg

Published in: Pediatric Surgery International | Issue 6/2016

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.

Capello SA et al (2005) Prenatal ultrasound has led to earlier detection and repair of ureteropelvic junction obstruction. J Urol 174(4 Pt 1):1425–1428CrossRefPubMed

Morin L et al (1996) Minimal hydronephrosis in the fetus: clinical significance and implications for management. J Urol 155(6):2047–2049CrossRefPubMed

Löfgren P, B.S., Daxberg E-L, Eriksson M, Holmdahl G, Sandin A, Sjövall H, Sjögren P (2014) Pediatric robotically assisted surgery for pyeloplasty and fundoplication. Regional activity-based HTA 2014

Anderson JC, Hynes W (1949) Retrocaval ureter; a case diagnosed pre-operatively and treated successfully by a plastic operation. Br J Urol 21(3):209–214CrossRefPubMed

Mei H et al (2011) Laparoscopic versus open pyeloplasty for ureteropelvic junction obstruction in children: a systematic review and meta-analysis. J Endourol 25(5):727–736CrossRefPubMed

Schuessler WW et al (1993) Laparoscopic dismembered pyeloplasty. J Urol 150(6):1795–1799PubMed

Peters CA, Schlussel RN, Retik AB (1995) Pediatric laparoscopic dismembered pyeloplasty. J Urol 153(6):1962–1965CrossRefPubMed

Troxel S et al (2006) Laparoscopy versus dorsal lumbotomy for ureteropelvic junction obstruction repair. J Urol 176(3):1073–1076CrossRefPubMed

Tan HL, Roberts JP (1996) Laparoscopic dismembered pyeloplasty in children: preliminary results. Br J Urol 77(6):909–913CrossRefPubMed

10.

Casale P (2009) Robotic pyeloplasty in the pediatric population. Curr Opin Urol 19(1):97–101CrossRefPubMed

11.

Palese MA et al (2005) Robot-assisted laparoscopic dismembered pyeloplasty. JSLS 9(3):252–257PubMedPubMedCentral

12.

Gettman MT et al (2002) A comparison of laparoscopic pyeloplasty performed with the daVinci robotic system versus standard laparoscopic techniques: initial clinical results. Eur Urol 42(5):453–457 (discussion 457-8) CrossRefPubMed

13.

Atug F et al (2005) Robotic assisted laparoscopic pyeloplasty in children. J Urol 174(4 Pt 1):1440–1442CrossRefPubMed

14.

Casale P (2008) Robotic pediatric urology. Expert Rev Med Devices 5(1):59–64CrossRefPubMed

15.

Passerotti C, Peters CA (2006) Pediatric robotic-assisted laparoscopy: a description of the principle procedures. Sci World J 6:2581–2588CrossRef

16.

Van Batavia JP, Casale P (2014) Robotic surgery in pediatric urology. Curr Urol Rep 15(5):402CrossRefPubMed

17.

Lee RS et al (2006) Pediatric robot assisted laparoscopic dismembered pyeloplasty: comparison with a cohort of open surgery. J Urol 175(2):683–687 (discussion 687) CrossRefPubMed

18.

Yee DS et al (2006) Initial comparison of robotic-assisted laparoscopic versus open pyeloplasty in children. Urology 67(3):599–602CrossRefPubMed

19.

Riachy E et al (2013) Pediatric standard and robot-assisted laparoscopic pyeloplasty: a comparative single institution study. J Urol 189(1):283–287CrossRefPubMed

20.

Barbosa JA et al (2013) Comparative evaluation of the resolution of hydronephrosis in children who underwent open and robotic-assisted laparoscopic pyeloplasty. J Pediatr Urol 9(2):199–205CrossRefPubMed

21.

Kutikov A et al (2006) Robot assisted pyeloplasty in the infant-lessons learned. J Urol 176(5):2237–2239 (discussion 2239-40) CrossRefPubMed

22.

Bansal D et al (2014) Infant robotic pyeloplasty: comparison with an open cohort. J Pediatr Urol 10(2):380–385CrossRefPubMed

23.

Shive ML et al (2012) Ureteral fibroepithelial polyp causing urinary obstruction. J Radiol Case Rep 6(7):23–28PubMedPubMedCentral

24.

Sorensen MD et al (2011) Comparison of the learning curve and outcomes of robotic assisted pediatric pyeloplasty. J Urol 185(6 Suppl):2517–2522CrossRefPubMed

25.

Freilich DA et al (2010) Parental satisfaction after open versus robot assisted laparoscopic pyeloplasty: results from modified Glasgow Children’s Benefit Inventory Survey. J Urol 183(2):704–708CrossRefPubMed

26.

Behan JW et al (2011) Human capital gains associated with robotic assisted laparoscopic pyeloplasty in children compared to open pyeloplasty. J Urol 186(4 Suppl):1663–1667CrossRefPubMed

27.

Olsen LH, Rawashdeh YF, Jorgensen TM (2007) Pediatric robot assisted retroperitoneoscopic pyeloplasty: a 5-year experience. J Urol 178(5):2137–2141 (discussion 2141) CrossRefPubMed

28.

Minnillo BJ et al (2011) Long-term experience and outcomes of robotic assisted laparoscopic pyeloplasty in children and young adults. J Urol 185(4):1455–1460CrossRefPubMed

29.

Lindgren BW et al (2012) Robot-assisted laparoscopic reoperative repair for failed pyeloplasty in children: a safe and highly effective treatment option. J Urol 188(3):932–937CrossRefPubMed

30.

Calisti A et al (2003) Functional outcome after pyeloplasty in children: impact of the cause of obstruction and of the mode of presentation. Eur Urol 43(6):706–710CrossRefPubMed

31.

Rowe CK et al (2012) A comparative direct cost analysis of pediatric urologic robot-assisted laparoscopic surgery versus open surgery: could robot-assisted surgery be less expensive? J Endourol 26(7):871–877CrossRefPubMed

Title: Pyeloplasty in children: perioperative results and long-term outcomes of robotic-assisted laparoscopic surgery compared to open surgery
Authors: Martin Salö
Tania Sjöberg Altemani
Magnus Anderberg
Publication date: 01-06-2016
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Surgery International / Issue 6/2016
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-016-3869-2

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Springer Medicine

Pyeloplasty in children: perioperative results and long-term outcomes of robotic-assisted laparoscopic surgery compared to open surgery

Abstract

Background

Objective

Patients and methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Objective

Patients and methods

Results

Conclusions

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