A comparative study of pediatric open pyeloplasty, laparoscopy-assisted extracorporeal pyeloplasty, and robot-assisted laparoscopic pyeloplasty.
PURPOSE:To compare the outcomes of open pyeloplasty (OP), laparoscopy-assisted extracorporeal (LEXP), and robotic-assisted laparoscopic pyeloplasty (RALP) for ureteropelvic junction obstruction in pediatric patients. METHODS:We retrospectively reviewed the age-matched cohort of 30 children who under...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2017-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC5398516?pdf=render |
| _version_ | 1819051291567980544 |
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| author | Sang Hoon Song Chanwoo Lee Jaeyoon Jung Sung Jin Kim Sungchan Park Hyungkeun Park Kun Suk Kim |
| author_facet | Sang Hoon Song Chanwoo Lee Jaeyoon Jung Sung Jin Kim Sungchan Park Hyungkeun Park Kun Suk Kim |
| author_sort | Sang Hoon Song |
| collection | DOAJ |
| description | PURPOSE:To compare the outcomes of open pyeloplasty (OP), laparoscopy-assisted extracorporeal (LEXP), and robotic-assisted laparoscopic pyeloplasty (RALP) for ureteropelvic junction obstruction in pediatric patients. METHODS:We retrospectively reviewed the age-matched cohort of 30 children who underwent OP, 30 who underwent LEXP, and 10 who underwent RALP at a single institution, from 1996 to 2014. Pre- and post-operative variables including success rate were compared among surgical groups. RESULTS:The mean age of the patients was 120.2 months, the Society for Fetal Urology grade was 3.6, the anteroposterior diameter was 3.1 cm, and the renal relative function was 44.0%. The distribution of laterality, mean body mass index, and preoperative anteroposterior pelvic diameter on ultrasound did not differ among groups. The mean length of hospital stay was significantly shorter in the RALP group (3.2 days) than in the OP (6.6 days) and LEXP (5.8 days) groups (p<0.001). The duration of analgesics use was shorter in the RALP group (1.1 days) than in the other groups (p<0.001). During the mean follow-up period of 49.0, 20.1, and 16.6 months, the success rate was 96.7%, 89.7%, and 100% in the OP, LEXP, and RALP groups, respectively, although this difference was not statistically different (p = 0.499). In multivariate regression analysis, the presence of crossing vessels was the only factor that decreased the success rate (hazard ratio: 46.09, 95% confidence interval: 2.41-879.6, p = 0.011). CONCLUSIONS:Patients who undergo RALP have a reduced hospital stay and lower use of pain medication; however, there is no difference in the success rates for OP, LP, and RALP surgeries. The presence of crossing vessels is a negative prognostic indicator for surgical outcome regardless of the surgical method. |
| first_indexed | 2024-12-21T12:01:36Z |
| format | Article |
| id | doaj.art-2af0dc332d454b3cb2ccbb9f87d8f708 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-21T12:01:36Z |
| publishDate | 2017-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-2af0dc332d454b3cb2ccbb9f87d8f7082022-12-21T19:04:49ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01124e017502610.1371/journal.pone.0175026A comparative study of pediatric open pyeloplasty, laparoscopy-assisted extracorporeal pyeloplasty, and robot-assisted laparoscopic pyeloplasty.Sang Hoon SongChanwoo LeeJaeyoon JungSung Jin KimSungchan ParkHyungkeun ParkKun Suk KimPURPOSE:To compare the outcomes of open pyeloplasty (OP), laparoscopy-assisted extracorporeal (LEXP), and robotic-assisted laparoscopic pyeloplasty (RALP) for ureteropelvic junction obstruction in pediatric patients. METHODS:We retrospectively reviewed the age-matched cohort of 30 children who underwent OP, 30 who underwent LEXP, and 10 who underwent RALP at a single institution, from 1996 to 2014. Pre- and post-operative variables including success rate were compared among surgical groups. RESULTS:The mean age of the patients was 120.2 months, the Society for Fetal Urology grade was 3.6, the anteroposterior diameter was 3.1 cm, and the renal relative function was 44.0%. The distribution of laterality, mean body mass index, and preoperative anteroposterior pelvic diameter on ultrasound did not differ among groups. The mean length of hospital stay was significantly shorter in the RALP group (3.2 days) than in the OP (6.6 days) and LEXP (5.8 days) groups (p<0.001). The duration of analgesics use was shorter in the RALP group (1.1 days) than in the other groups (p<0.001). During the mean follow-up period of 49.0, 20.1, and 16.6 months, the success rate was 96.7%, 89.7%, and 100% in the OP, LEXP, and RALP groups, respectively, although this difference was not statistically different (p = 0.499). In multivariate regression analysis, the presence of crossing vessels was the only factor that decreased the success rate (hazard ratio: 46.09, 95% confidence interval: 2.41-879.6, p = 0.011). CONCLUSIONS:Patients who undergo RALP have a reduced hospital stay and lower use of pain medication; however, there is no difference in the success rates for OP, LP, and RALP surgeries. The presence of crossing vessels is a negative prognostic indicator for surgical outcome regardless of the surgical method.http://europepmc.org/articles/PMC5398516?pdf=render |
| spellingShingle | Sang Hoon Song Chanwoo Lee Jaeyoon Jung Sung Jin Kim Sungchan Park Hyungkeun Park Kun Suk Kim A comparative study of pediatric open pyeloplasty, laparoscopy-assisted extracorporeal pyeloplasty, and robot-assisted laparoscopic pyeloplasty. PLoS ONE |
| title | A comparative study of pediatric open pyeloplasty, laparoscopy-assisted extracorporeal pyeloplasty, and robot-assisted laparoscopic pyeloplasty. |
| title_full | A comparative study of pediatric open pyeloplasty, laparoscopy-assisted extracorporeal pyeloplasty, and robot-assisted laparoscopic pyeloplasty. |
| title_fullStr | A comparative study of pediatric open pyeloplasty, laparoscopy-assisted extracorporeal pyeloplasty, and robot-assisted laparoscopic pyeloplasty. |
| title_full_unstemmed | A comparative study of pediatric open pyeloplasty, laparoscopy-assisted extracorporeal pyeloplasty, and robot-assisted laparoscopic pyeloplasty. |
| title_short | A comparative study of pediatric open pyeloplasty, laparoscopy-assisted extracorporeal pyeloplasty, and robot-assisted laparoscopic pyeloplasty. |
| title_sort | comparative study of pediatric open pyeloplasty laparoscopy assisted extracorporeal pyeloplasty and robot assisted laparoscopic pyeloplasty |
| url | http://europepmc.org/articles/PMC5398516?pdf=render |
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