Minimally invasive versus open pyeloplasty in pediatric population: Comparative retrospective study in tertiary centre

Abstract

Background: Ureteropelvic junction obstruction (UPJO) is the most common cause of antenatal hydronephrosis. The incidence is around 1: 750–1500 live births. The standard treatment for (UPJO) is open pyeloplasty (OP) with a high success rate of 90%–95%. In the last 20 years, minimal invasive pyeloplasty (MIP) became an excellent alternative technique to OP which was historically the standard of care. Materials and Methods: The study participants were male and female patients aged 14 years old or less who had undergone open/minimally invasive pyeloplasty during 2015–2020 and who had at least 1-year follow-up after surgery. The data were collected retrospectively from patients’ charts. The patients were categorized into two cohort groups: OP and on the other arm minimally invasive pyeloplasty (robotic/laparoscopic) comparing the outcomes as a 1ry endpoint. 2ry endpoints were hospital stay, duration of surgery, and anteroposterior diameter of renal ultrasound. Results: A total of 133 patients were included in the study. Eighty-four underwent MIP while 49 patients underwent OP. 1ry endpoint was the success rate in both groups. The success rate was 94% ( n : 79) and 98% ( n : 48) in patients who underwent MIP and OP, respectively. P <0.05 is considered significant. Conclusion: Open and minimally invasive pyeloplasty are comparable in terms of success rate. However, OP was associated with shorter hospital stays and shorter operative times.