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

Autor:	González ST; Department of Urology, Universidad Nacional de la Plata - UNLP, La Plata, Buenos Aires.; Department of Urology, Hospital Interzonal Especializado en Pediatría 'Sor María Ludovica', La Plata, Buenos Aires, Argentina., Rosito TE; Departamento de Urologia, Grupo de Urologia Reconstrutiva e Infantil (GURI), Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil.; Programa de Pós-graduação em Ginecologia e Obstetrícia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil., Tur AB; Department Pediatric Urology, Fundació Puigvert, Barcelona, Catalunya, Spain., Ruiz J; Department of Urology, Hospital Pediatric Prof. Dr. Juan P. Garrahan, Ciudad Autonoma de Buenos Aires, Buenos Aires, Argentina., Gozalbez R; Division of Pediatric Urology, Nicklaus Children's Hospital, Miami, FL, United States., Maiolo A; Department of Urology, Hospital Interzonal Especializado en Pediatría 'Sor María Ludovica', La Plata, Buenos Aires, Argentina., Tavares PM; Departamento de Urologia, Grupo de Urologia Reconstrutiva e Infantil (GURI), Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil.; Programa de Pós-graduação em Ginecologia e Obstetrícia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil., Gorgen ARH; Departamento de Urologia, Grupo de Urologia Reconstrutiva e Infantil (GURI), Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil., de Kencht EL; Department Pediatric Urology, Fundació Puigvert, Barcelona, Catalunya, Spain., Madarriaga YQ; Department Pediatric Urology, Fundació Puigvert, Barcelona, Catalunya, Spain., Weller S; Department of Urology, Hospital Pediatric Prof. Dr. Juan P. Garrahan, Ciudad Autonoma de Buenos Aires, Buenos Aires, Argentina., Tobia IP; Department of Urology, Universidad Nacional de la Plata - UNLP, La Plata, Buenos Aires., Castellan M; Division of Pediatric Urology, Nicklaus Children's Hospital, Miami, FL, United States., Corbetta JP; Department of Urology, Hospital Pediatric Prof. Dr. Juan P. Garrahan, Ciudad Autonoma de Buenos Aires, Buenos Aires, Argentina.
Jazyk:	angličtina
Zdroj:	International braz j urol : official journal of the Brazilian Society of Urology [Int Braz J Urol] 2022 Nov-Dec; Vol. 48 (6), pp. 961-968.
DOI:	10.1590/S1677-5538.IBJU.2022.0194
Abstrakt:	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. Competing Interests: None declared. (Copyright® by the International Brazilian Journal of Urology.)
Databáze:	MEDLINE
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