Comparative evaluation of the resolution of hydronephrosis in children who underwent open and robotic-assisted laparoscopic pyeloplasty - Abstract

OBJECTIVES: To assess long-term postoperative ultrasonographic outcomes of robotic-assisted laparoscopic pyeloplasty (RALP) and of conventional open pyeloplasty (COP) in pediatric patients with ureteropelvic junction obstruction.

METHODS: Retrospective review of 312 patients who underwent RALP or COP in a single institution. Preoperative and postoperative ultrasounds were used to determine the grade of hydronephrosis. Postoperative assessment included 3 ultrasounds at 0-6, 6-12 and >12 months intervals. Patients were matched by age, etiology of obstruction, grade of preoperative hydronephrosis and gender for case-matched analysis.

RESULTS: We identified 212 pyeloplasties that met inclusion criteria, being 58 RALP and 154 COP. Groups were different in age, gender and etiology, but similar in severity of hydronephrosis and follow-up time. At the end of follow-up, complete resolution and success rates were 62% and 74% in RALP and 45% and 70% in COP, respectively. Matching included 105 patients. Complete resolution was higher in RALP (p = 0.004), while median time before improvement was lower (12.3 months RALP vs 29.9 months COP). There was no difference in success rate at the end of follow-up between the groups.

CONCLUSION: RALP shows satisfactory long-term outcomes, comparable to COP. In our cohort, patients who underwent robotic pyeloplasty showed faster resolution of hydronephrosis on ultrasound.

Written by:
Barbosa JA, Kowal A, Onal B, Gouveia E, Walters M, Newcomer J, Chow J, Nguyen HT   Are you the author?
Department of Urology, Hunnewell-353, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, USA; University of Sao Paulo School of Medicine, Department of Urology, Av. Dr Arnaldo, 455, Sao Paulo, SP, CEP 01246-903, Brazil

Reference: J Pediatr Urol. 2012 Feb 29
doi: 10.1016/j.jpurol.2012.02.002


PubMed Abstract
PMID: 22386726