Comparing the efficacy and safety between robotic-assisted versus open pyeloplasty in children: a systemic review and meta-analysis

Chang, Shang‐Jen; Hsu, Chun‐Kai; Hsieh, Cheng‐Hsing; Yang, Stephen Shei‐Dei

doi:10.1007/s00345-015-1526-3

Cited by 31 publications

(11 citation statements)

References 26 publications

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“…[40–42] During the past 5 years, many authors from established general thoracic centers reported studies that supported the feasibility, reproducibility, effectiveness, and safety of the robotic-assisted procedures compared with the open thymectomy. [24,31–36] To the best of our knowledge, this is the first meta-analysis comparing these 2 surgical techniques of thymectomy.…”

Section: Discussionmentioning

confidence: 99%

Thymectomy via open surgery or robotic video assisted thoracic surgery

Buentzel¹,

Straube²,

Heinz³

et al. 2017

Medicine

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Background:Robot-assisted minimally invasive surgery (RVATS) is a relatively new technique applied for thymectomies. Only few studies directly compare RVATS to the mainstay therapy, open surgery (sternotomy).Methods:A systematic search of the literature was performed in October 2016. The meta-analysis includes studies comparing robotassisted and open thymectomy regarding operation time, length of hospitalization, intraoperative blood loss, and chest-in-tube days, postoperative complications, reoperation, arrhythmic events, pleural effusion, and postoperative bleeding.Results:Of 626 studies preliminary screened, 7 articles were included. There were no significant differences in comparison of operation time (−3.19 minutes [95% confidence interval, 95% CI −112.43 to 106.05]; P = .94), but patients undergoing RVATS spent significantly less time in hospital (−4.06 days [95% CI −7.98 to −0.13], P = .046). There were fewer chests-in-tube days (−2.50 days [95% CI −15.01 to 10.01]; P = .24) and less intraoperative blood loss (−256.84 mL [95% CI −627.47 to 113.80]; P = .10) observed in the RVATS group; due to a small number of studies, these results were not statistically significant. There were also less post-operative complications in the RVATS group (12 complications in 209 patients vs 51 complications in 259 patients); however, this difference was not statistical significant (odds ratio 0.27, 95% CI 0.07–1.12; P = .06).Conclusions:Patients undergoing RVATS spent less time in hospital than patients treated by open surgery (sternotomy). These patients tended to have less postoperative complications, less intraoperative blood loss, and fewer chest-in-tube days. We found evidence for the safety and feasibility of RVATS compared with open surgery, which has to be further confirmed in randomised controlled trials.

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Section: Discussionmentioning

confidence: 99%

Thymectomy via open surgery or robotic video assisted thoracic surgery

Buentzel¹,

Straube²,

Heinz³

et al. 2017

Medicine

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“…Treatment of choice is surgery in case of flank pain, loss of DRF, or relevant obstruction in dynamic renal scans. The dismembered pyeloplasty (DMP) is the gold standard to successfully treat both intrinsic and extrinsic UPJO in children; recently published reports proved comparable results for laparoscopic, one trocar-assisted, or robotic-assisted dismembered pyeloplasty (LDMP, OTAP, RDMP), even in small infants [9,10]. Furthermore, in adults, nondismembered pyeloplasty…”

Section: Introductionmentioning

confidence: 94%

Differences between intrinsic and extrinsic ureteropelvic junction obstruction related to crossing vessels: histology and functional analyses

Ellerkamp¹,

Kurth²,

Schmid³

et al. 2015

World J Urol

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“…The post-operative success rate was comparable in the 2 groups, but there was a significantly higher complication rate and higher costs in the robotic group. 38 Additionally, it has been shown that with 2 years of follow-up, only 5% of patients who underwent robotic pyeloplasty require a secondary procedure, compared with 13% of those who underwent a standard laparoscopic pyeloplasty. 39 Moreover, robot-assisted laparoscopic reoperative repair after failed primary treatment is safe and effective, and is less technically demanding than open repair for UPJO.…”

Section: Robot-assisted Pyeloplastymentioning

confidence: 99%

Hydronephrosis in the course of ureteropelvic junction obstruction - an underestimated problem?Current opinion on pathogenesis, diagnosis and treatment.

et al. 2017

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Ureteropelvic junction obstruction (UPJO) causes a reduction in the urine flow from the renal pelvis into the ureter. Untreated UPJO may cause hydronephrosis, chronic infection or urolithiasis and will often result in progressive deterioration of renal function. Most cases of UPJO are congenital; however, the disease can be clinically silent until adulthood. Other causes, both intrinsic and extrinsic, are acquired and include urolithiasis, post-operative/inflammatory/ischemic stricture, fibroepithelial polyps, adhesions and malignancy. In the past, the most frequent symptom of UPJO in neonates and infants was a palpable flank mass. Nowadays, thanks to the widespread use of maternal and prenatal ultrasound examinations, asymptomatic hydronephrosis is diagnosed very early. In adults and older children symptoms may include intermittent abdominal or flank pain, nausea, vomiting and hematuria. In addition to high specificity and sensitivity in detecting UPJO, modern technologically advanced equipment such as ultrasound, magnetic resonance imaging and computed tomography provides a lot of information about the function of the affected kidney and the anatomy of the surrounding tissues. Treatment options for UPJO include a wide spectrum of approaches, from active surveillance or minimally invasive endourologic techniques to open, laparoscopic or robotic pyeloplasty. The main goal of therapy is to relieve symptoms and maintain or improve renal function, but it is difficult to define treatment success after UPJO therapy.

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Comparing the efficacy and safety between robotic-assisted versus open pyeloplasty in children: a systemic review and meta-analysis

Abstract: Robotic-assisted pyeloplasty may be a promising alternative minimal invasive surgery for UPJO in children if the higher complication rates and higher costs in the RP can be overcome in the near future.

Cited by 31 publications

References 26 publications

Thymectomy via open surgery or robotic video assisted thoracic surgery

Thymectomy via open surgery or robotic video assisted thoracic surgery

Differences between intrinsic and extrinsic ureteropelvic junction obstruction related to crossing vessels: histology and functional analyses

Hydronephrosis in the course of ureteropelvic junction obstruction - an underestimated problem?Current opinion on pathogenesis, diagnosis and treatment.

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