Laparoscopic vs Open Pyeloplasty in Children: Results of a Randomized, Prospective, Controlled Trial.

Creator(s)

John M. Gatti, Children's Mercy HospitalFollow
Sable P. Amstutz
Paul R. Bowlin, Children's Mercy HospitalFollow
Heidi A. Stephany
J Patrick Murphy, Children's Mercy Hospital

Document Type

Article

Publication Date

3-1-2017

Identifier

DOI: 10.1016/j.juro.2016.10.056

Abstract

PURPOSE: Open dismembered pyeloplasty is the preferred repair for ureteropelvic junction obstruction. Minimally invasive techniques have been applied to the original open approach but no clear advantage has been demonstrated for these technological advances. We evaluate outcomes between transperitoneal laparoscopic and open pyeloplasty in children.

MATERIALS AND METHODS: All children 1 to 18 years old with ureteropelvic junction obstruction requiring operative repair were offered enrollment in the study. Patients were prospectively randomized to either laparoscopic or open pyeloplasty through a flank incision.

RESULTS: A total of 50 patients in the laparoscopic group and 48 in the open group were enrolled from 2005 to 2014. Mean followup was similar between the groups (13.7 months in the laparoscopic group vs 12.3 months in the open group, p = 0.54). The only significantly different outcomes were for mean operative time, which was 139.5 minutes (range 94 to 213) in the laparoscopic group and 122.5 minutes (83 to 239) in the open group (p

CONCLUSIONS: Open and laparoscopic dismembered pyeloplasty are comparable and effective methods for repair of ureteropelvic junction obstruction. Although operative time was statistically shorter in the open group and length of stay was shorter in the laparoscopic group, the clinical significance of these variables is questionable. The approach to repair may best be based on family preference for incision aesthetics and surgeon comfort with either approach, rather than more classically objective outcome measures.

Journal Title

The Journal of urology

Volume

197

Issue

3 Pt 1

First Page

792

Last Page

797

MeSH Keywords

Ureteral Obstruction/Surgery; Minimally Invasive Surgical Procedures; Comparative Study; Infant; Child

Keywords

laparoscopy; minimally invasive surgical procedures; randomized controlled trials as topic; ureteral obstruction

Recommended Citation

Gatti JM, Amstutz SP, Bowlin PR, Stephany HA, Murphy JP. Laparoscopic vs Open Pyeloplasty in Children: Results of a Randomized, Prospective, Controlled Trial. J Urol. 2017;197(3 Pt 1):792-797. doi:10.1016/j.juro.2016.10.056