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Minerva Urologica e Nefrologica 2018 October;70(5):486-93

DOI: 10.23736/S0393-2249.18.03106-5

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Robotic versus open pyeloplasty in pediatric patients: a single center experience in Saudi Arabia

Noor N. JUNEJO 1, 2 , Santiago VALLASCIANI 2, 3, Ahmad ALSHAMMARI 4, Hossam ALJALLAD 2, Saeed ALSHAHRANI 2, Abdulazeem ABASHER 2, Ahmed ALMATHAMI 2, Hamdan ALHAZMI 5

1 Department of Urology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; 2 Division of Pediatric Urology, Department of Urology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; 3 College of Medicine, Alfaisal University, Riyadh, Saudi Arabia; 4 Division of Pediatric Urology, Department of Surgery, King Abdul-Aziz Medical City, King Fahad National Guard Hospital, Riyadh, Saudi Arabia; 5 Division of Urology, Department of Surgery, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia



BACKGROUND: Robotic surgery in pediatric patients is performed in our center since 2013. This study aims to analyze the evolution of robot-assisted laparoscopic pyeloplasty (RALP) in our center to investigate its feasibility and safety compared with open pyeloplasty (OP) technique.
METHODS: In this retrospective study, patients aged 2 to 14 years who underwent pyeloplasty procedure for ureteropelvic junction obstruction were divided into two groups according to the type of surgical approach (RALP and OP). The median age, weight, duration of the procedure, length of hospital stays, complication according to the Clavien grading system and success rates were recorded. We determined any trends in RALP activity, the length of hospital stay, and the patients’ weight. We also compared the results of two equally divided periods (January 2015 to March 2016 and April 2016 to June 2017).
RESULTS: Forty-one pyeloplasty were performed in this study. RALP and OP were performed in 26 (57.8%) and 15 (33.3%) cases, respectively. RALP was more utilized than OP in the second period (19 vs. 7). Comparing the two periods, a reduction in the median weight in the RALP group was observed (P=0.039); in the OP group, the weight remained almost unchanged (15 vs. 18 kg). The median duration of OP was shorter than that of RALP (P<0.04). The length of hospital stays reduced in the RALP group (P=0.013).
CONCLUSIONS: RALP is safe and feasible and has a promising potential in pediatric urology. The rapid and favorable evolution in the studied indicators shows encouraging results as the indications for RALP are expanded and the length of hospital stay shortened.


KEY WORDS: Robotics - Pediatrics - Kidney pelvis

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