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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 PLoS+One
2017 ; 12
(4
): e0175026
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A comparative study of pediatric open pyeloplasty, laparoscopy-assisted
extracorporeal pyeloplasty, and robot-assisted laparoscopic pyeloplasty
#MMPMID28426695
Song SH
; Lee C
; Jung J
; Kim SJ
; Park S
; Park H
; Kim KS
PLoS One
2017[]; 12
(4
): e0175026
PMID28426695
show ga
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.