Bi-institutional comparison of robot-assisted laparoscopic versus open ureteroureterostomy in the pediatric population

Nora G. Lee, Sean T. Corbett, Kaitlan Cobb, George C. Bailey, Amy S. Burns, Craig A Peters

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Purpose: Ureteroureterostomy (UU) is a useful surgical option for the management of duplication anomalies as well as obstructed single system ureters for children. We aimed to evaluate the safety, efficacy, and outcomes of robot-assisted laparoscopic UU (RALUU) compared with open UU (OUU) in the pediatric population. Patients and Methods: A retrospective review was performed at two institutions including six surgeons' experience with all cases of RALUU and OUU from January 2005 to June 2014. Indications for a surgical procedure included duplex systems with an upper pole ectopic ureter, obstructed ureterocele or lower pole vesicoureteral reflux, and obstruction in a single system. Transureteroureterostomy, laparoscopic UU, and major reconstruction cases where UU was the secondary procedure were excluded. Results: There were 25 RALUU and 19 OUU cases included. All cases involved duplex systems except two proximal to distal anastomoses in single system obstructed kidneys. RALUUs were more likely to be performed proximally (P = 0.01) and with the use of cystoscopy and stent placement (P = <0.0001). Operative times and estimated blood loss were similar between the two groups. Postoperative complications included four febrile urinary tract infections in each group, one recurrence of nonfebrile urinary tract infection in the open group, and one postoperative obstruction at the ureterovesical junction because of attempted stent placement necessitating nephrostomy tube placement in the open group. This OUU patient was the only one to demonstrate more severe hydronephrosis after surgery on initial follow-up imaging that was again unrelated to the open UU procedure. RALUU had shorter hospital stays by 0.5 days (P = 0.04). Conclusion: Robot-assisted laparoscopic UU is a safe and effective alternative to open UU in children with duplication anomalies and single system obstructed ureters. Operative times and complication rates were comparable with slightly shorter length of hospitalization in robotic cases.

Original languageEnglish (US)
Pages (from-to)1237-1241
Number of pages5
JournalJournal of Endourology
Volume29
Issue number11
DOIs
StatePublished - Jan 1 2015

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Ureter
Pediatrics
Operative Time
Urinary Tract Infections
Population
Stents
Ureterocele
Vesico-Ureteral Reflux
Cystoscopy
Hydronephrosis
Robotics
Length of Stay
Hospitalization
Fever
Kidney
Safety
Recurrence

ASJC Scopus subject areas

  • Urology
  • Medicine(all)

Cite this

Bi-institutional comparison of robot-assisted laparoscopic versus open ureteroureterostomy in the pediatric population. / Lee, Nora G.; Corbett, Sean T.; Cobb, Kaitlan; Bailey, George C.; Burns, Amy S.; Peters, Craig A.

In: Journal of Endourology, Vol. 29, No. 11, 01.01.2015, p. 1237-1241.

Research output: Contribution to journalArticle

Lee, Nora G. ; Corbett, Sean T. ; Cobb, Kaitlan ; Bailey, George C. ; Burns, Amy S. ; Peters, Craig A. / Bi-institutional comparison of robot-assisted laparoscopic versus open ureteroureterostomy in the pediatric population. In: Journal of Endourology. 2015 ; Vol. 29, No. 11. pp. 1237-1241.
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