Abstract Book - 26th ESPU Congress, Joint Meeting with ICCS + SPU + AAP/SOU + AAPU + SFU

346 / 492

16:16 - 16:19
S28-4 (PP)
GLOBAL MINIMALLY INVASIVE PYELOPLASTY STUDY IN CHILDREN: RESULTS
FROM THE PEDIATRIC UROLOGY EXPERT GROUP OF THE EAU YOUNG ACADEMIC
UROLOGISTS WORKING PARTY
Mesrur Selcuk SILAY1, Radim KOCVARA2, Shabnam UNDRE3, Anne-Francoise SPINOIT4, Gwen GRIMSBY5, Tatiana
GARMANOVA6, Zafer TANDOGDU7, Andrea GUTTILA8, Ahmet Ali SANCAKTUTAR9, Bernhard HAID10, Matthias WALDERT11,
Anju GOYAL 12, Ege Can SEREFOGLU 13, Emanuele BALDASSARRE14, Giantonio MANZONI 15, Anna RADFORD16, Ramnath
SUBRAMANIAM16, Vojtech FIALA2, Abraham CHERIAN17, Piet HOEBEKE4, Patricio C GARGOLLO18, Rudin YURIY6, Fabio
ZATTONI8 and Chester J KOH18
1) BEZMIALEM VAKIF UNIVERSITY, DIVISION OF PEDIATRIC UROLOGY, DEPARTMENT OF UROLOGY, Istanbul, TURKEY -
2) General Teaching Hospital in Prague and Charles University-1st, DEPARTMENT OF UROLOGY, Prague, CZECH
REPUBLIC - 3) Great Ormond Street Hospital, DEPARTMENT OF UROLOGY, London, UNITED KINGDOM - 4) UNIVERSITY
OF GHENT, DEPARTMENT OF UROLOGY, Ghent, BELGIUM - 5) Children's Medical Center, DEPARTMENT OF UROLOGY,
Dallas, USA - 6) Institute of Moscow, DEPARTMENT OF UROLOGY, Moscow, RUSSIAN FEDERATION - 7) Newcastle
University, DEPARTMENT OF UROLOGY, Newcastle, UNITED KINGDOM - 8) University of Padua, DEPARTMENT OF
UROLOGY, Padua, ITALY - 9) DICLE UNIVERSITY, DEPARTMENT OF UROLOGY, Diyarbakir, TURKEY - 10) Sisters of the
Charity Hospital, DEPARTMENT OF PEDIATRIC UROLOGY, Linz, AUSTRIA - 11) UNIVERSITY OF VIENNA, DEPARTMENT
OF PEDIATRIC UROLOGY, Vienna, AUSTRIA - 12) UNIVERSITY OF MANCHESTER, DEPARTMENT OF PEDIATRIC
UROLOGY, Manchester, UNITED KINGDOM - 13) Bagcilar Training and Research Hospital, DEPARTMENT OF UROLOGY,
Istanbul, TURKEY - 14) Umberto Parini Hospital, DEPARTMENT OF UROLOGY, Aosta, TURKEY - 15) Policlinico,
DEPARTMENT OF UROLOGY, Milan, ITALY - 16) St James University Hospital, DEPARTMENT OF PEDIATRIC UROLOGY,
Leeds, UNITED KINGDOM - 17) Great Ormond Street Hospital, DEPARTMENT OF PEDIATRIC UROLOGY, London, UNITED
KINGDOM - 18) TEXAS CHILDRENS HOSPITAL AND BAYLOR COLLEGE OF MEDICINE, DEPARTMENT OF UROLOGY,
Houston, USA
PURPOSE
Minimally invasive pyeloplasty for UPJ obstruction in children has expanded globally over the past decade as an
alternative to open surgery. Our goals were to identify the factors affecting complication rates of minimally invasive
pyeloplasty in children and to compare the outcomes of laparoscopic and robotic pyeloplasty.
MATERIAL AND METHODS
We retrospectively evaluated the perioperative data involving 783 pediatric patients (< 18 years old) from 15 academic
centers who underwent either laparoscopic or robotic pyeloplasty with an Anderson Hynes dismembered pyeloplasty
technique. Redo cases and patients with anatomic renal abnormalities were excluded. Demographics and operative data
including procedural factors were collected. Complications were classified according to the Satava and modified Clavien
systems. Failure was defined as any of the following; obstructive parameters on diuretic renal scintigraphy, decline in
renal function, progressive hydronephrosis, or symptom relapse. Univariate and multivariate analysis were applied to
identify factors affecting the complication rates. All parameters were compared between laparoscopic and robotic
approach.
RESULTS
A total of 575 children met the inclusion criteria. Laparoscopy, increased operative time, prolonged hospital stay,
stenting technique and time required for stenting were factors influencing complication rates on univariate analysis.
None of those factors remained significant on multivariate analysis. Mean follow-up was 12.8±9.8 months for robotic
and 45.2±33.8 months for laparoscopic pyeloplasty (p<0.01). Hospital stay and time for stenting were shorter for
robotic pyeloplasty (p<0.05). Success rates were similar between robotic and laparoscopic pyeloplasties (99.5%
vs.97.3%). Postoperative complication was 7.7% for laparoscopic pyeloplasty and 3.2% for robotic pyeloplasty
(p<0.05). All complications were of no greater severity than Satava grade III and Clavien grade IV.
CONCLUSIONS
Minimally invasive pyeloplasty is safe and effective in treating UPJ obstruction in children in many centers globally.