Robot-assisted versus laparoscopic pyeloplasty for patients with ureteropelvic junction obstruction: An updated systematic review and meta-analysis

Wang, Furan; Xu, Yuan; Zhong, Hongji

doi:10.3109/21681805.2013.780184

Cited by 21 publications

(18 citation statements)

References 28 publications

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“…Our results are equal to a recent meta-analysis by Wang et al who shows an overall effect on laparoscopic pyeloplasty on 88% of the patients [5]. …”

Section: Discussionsupporting

confidence: 71%

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Laparoscopic Pyeloplasty for Ureteropelvic Junctions Obstruction in Adults: 6 Years’ Experience in One Center

Tolstrup

Pank

Sander

et al. 2017

BioMed Research International

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Objective Ureteropelvic junction obstruction (UPJO) is a common cause of symptomatic ureteral obstruction. The aim of this study is to assess the outcome of laparoscopic pyeloplasty in patients with UPJO. Patients and Methods Medical reports of 47 UPJO patients treated with laparoscopic pyeloplasty were retrospectively analysed. All patients were recruited from our center in the period 2004–2011. Results We evaluated 47 patients. Mean age was 36 years and mean hospital stay 3.6 days. 42 (79%) of the patients had pain and 46 (98%) were diagnosed with hydronephrosis. 19 patients (40%) had a renal function below 40% of the affected kidney and 49% had impaired renal scan drainage. Postoperative significant improvement in pain score and renal scan drainage was found in 92% and 47% of the patients, respectively. Improvement of renal function > 10% was found in 11 patients (23%); the function remained stable in 31 patients (66%) and deteriorated > 10% in 5 patients (11%). We found no correlation between sex or age and the outcome. Conclusion Laparoscopic pyeloplasty for UPJO leads to relief of pain and preserved or improved renal function in the majority of the patients. Overall laparoscopic pyeloplasty is an efficient treatment for UPJO.

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“…Our results are equal to a recent meta-analysis by Wang et al who shows an overall effect on laparoscopic pyeloplasty on 88% of the patients [5]. …”

Section: Discussionsupporting

confidence: 71%

“…Furthermore, the robot-assisted procedure has better ergonomics for the surgeon, which improves the success rate of suturing the anastomosis due to more degrees of freedom for movements [5, 9]. …”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Pyeloplasty for Ureteropelvic Junctions Obstruction in Adults: 6 Years’ Experience in One Center

Tolstrup

Pank

Sander

et al. 2017

BioMed Research International

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“…In our meta-analyses, RAP had a significantly lower complication rate (P = 0.005) and significantly higher success rate (P = 0.008). In previous meta-analyses where success and complication rates were similar in the two groups, these were not surprising findings [4][5][6]. RAP and LP both aim to replicate the already impressive success rates of open pyeloplasty.…”

Section: Complication and Success Ratesmentioning

confidence: 59%

Peri‐operative outcomes and complications after laparoscopic vs robot‐assisted dismembered pyeloplasty: a systematic review and meta‐analysis

et al. 2018

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For patients with PUJ obstruction, our meta-analyses show that RAP is advantageous concerning operating time, length of hospital stay, complication rate and success rate. Our conclusions, however, are weakened by poor quality of evidence and significant study heterogeneity. In addition, whether the statistical significance observed in the present meta-analysis translates into clinical significance is an important question. Further high-quality studies, particularly randomized controlled trials, are necessary to strengthen conclusions.

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“…The complication rate in our patients was low (5%), with a maximum Clavien grade III (one port hernia and one JJ stent dislocation). Other large series report complication rates of 6-11%, most complications not being higher than Clavien III [2,7,9,10,20].…”

Section: Discussionmentioning

confidence: 94%

One‐ vs 4‐week stent placement after laparoscopic and robot‐assisted pyeloplasty: results of a prospective randomised single‐centre study

et al. 2014

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ObjectivesTo determine whether 1-week stenting of the pelvi-ureteric anastomosis of laparoscopic or robot-assisted pyeloplasty is as effective as 4-week stenting, based on their respective success rates. Patients and MethodsA total of 100 patients with pelvi-ureteric junction obstruction were treated by Anderson-Hynes pyeloplasty and the anastomosis was stented using a 6-F JJ catheter for either 1 week (1W series) or 4 weeks (4W series), based on a randomisation protocol. Postoperative follow-up was performed at 3 months using intravenous urography (IVU), at 6 months using diuretic renography and at 1, 3 and 5 years using ultrasonography. Statistical analysis was performed using a one-sided Z-test, Pearsons's chi-squared test and a Wilcoxon rank sum test. ResultsThe primary outcome measure, success rate, which was defined as no obstruction on IVU and diuretic renography, was 100% in the 1W series and not inferior to the success rate of 98% in the 4W series (P = 0.006). The following secondary outcome measures were not significantly different between the 1W and the 4W series with regard to residual symptoms (10 vs 6%; P = 0.48), rate of complications (4 vs 6%; P = 0.65), need for synchronous robot-assisted pyelolithotomy (4 vs 8%; P = 0.47), improvement in split renal function (1 vs 0%; P = 0.59) and duration of surgery (200 vs 192 min; P = 0.87). Only length of hospital stay was significantly different; this was shorter in the 1W series (5 vs 6 days; P = 0.01). ConclusionsStenting of the pelvi-ureteric anastomosis after laparoscopic or robot-assisted pyeloplasty for 1 week is as effective as stenting for 4 weeks. Both procedures, laparoscopic or robot-assisted pyeloplasty have an excellent success rate.

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Robot-assisted versus laparoscopic pyeloplasty for patients with ureteropelvic junction obstruction: An updated systematic review and meta-analysis

Cited by 21 publications

References 28 publications

Laparoscopic Pyeloplasty for Ureteropelvic Junctions Obstruction in Adults: 6 Years’ Experience in One Center

Laparoscopic Pyeloplasty for Ureteropelvic Junctions Obstruction in Adults: 6 Years’ Experience in One Center

Peri‐operative outcomes and complications after laparoscopic vs robot‐assisted dismembered pyeloplasty: a systematic review and meta‐analysis

One‐ vs 4‐week stent placement after laparoscopic and robot‐assisted pyeloplasty: results of a prospective randomised single‐centre study

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