Table 3.
Selected contemporary series on pediatric pyeloplasty including at least 50 cases
| References | Approach (No.) | Age (yrs) | Followup (mos) | Definition of Success | % Success | Imaging Followup Protocol |
|---|---|---|---|---|---|---|
| Chacko et al4 | Laparoscopic transperitoneal (52) | Mean 4.3 | Mean 20 | Absence of symptoms + improved hydronephrosis (US) or improved drainage (RS) | 98 | – |
| Maheshwari et al5 | Laparoscopic transperitoneal (82) | Mean 7.1 | Mean 41.6 | Absence of obstruction on RS | 92 | – |
| Szavay et al6 | Laparoscopic transperitoneal (70) | Median 1.7 | Median 24 | – | 98 | US every 3 mos; MAG3 at 3 mos, 12 mos |
| Sweeney et al7 | Laparoscopic transperitoneal (112) | Mean 9.4 | Mean 15.3 | Symptoms and/or radiographic evidence of obstruction | 97 | – |
| Olsen et al8 | Robotic retroperitoneal (67) | Mean 7.9 | Median 12.1 | Absence of symptoms and/or decreased intrarenal pelvis anteroposterior diameter (US), or unchanged or improved differential function (RS) | 94 | US + RS at 3 mos, 12 mos |
| Minnillo et al9 | Robotic transperitoneal (155) | Mean 10.5 | Mean 31.7 | Improved symptoms, improved hydronephrosis (US) and/or improved drainage parameters (RS) | 96 | US at 1 mo, 3 mos, then yearly; MAG3 if recurrent symptoms or not improved on US |
| Zhou et al10 | Laparoscopic retroperitoneal (62) | Mean 3 | Mean 24 | – | 98 | IVP + US at 3 mos, 6 mos, then yearly |
| Blanc et al11 | Laparoscopic retroperitoneal (104) | Mean 6.2 | Median 25.2 | Decreased or resolved hydronephrosis (US) + improved drainage with residual less than 50% at 20 mins after furosemide administration with stable differential function (RS) | 96 | US 1 mo after stent removal (6 wks), every 3 mos for 1 yr, then yearly for 5 yrs; MAG3 or magnetic resonance urography if no significant improvement on US, recurrent symptoms or significant preop asymmetrical function |
| Piaggio et al12 | Laparoscopic transperitoneal (37) vs open (41) | Mean 5.1 vs 3.7 | Mean 6.3 vs 24 | Symptom resolution, marked reduction of hydronephrosis (US) or improved drainage curve (RS) | 97 Vs 83 | – |
| Valla et al13 | Laparoscopic retroperitoneal (45) vs open (45) | Mean 5.8 vs 1.8 | Mean 25 vs 38 | Symptom improvement + improved hydronephrosis (US) or renal drainage/function (RS) | 97 Vs 96 | US at 3–6 mos, then yearly; RS at 1 yr |
| Braga et al14 | Laparoscopic transperitoneal (41) vs open (67) | Mean 7.9 vs 8.1 (flank), 7.3 (dorsal) | Mean 28 vs 49 (flank), 47 (dorsal) | Symptom resolution, improved hydronephrosis (US) and/or decreased t1/2 at last clinical appointment (RS) | 95 Vs 96 | Routine US; RS reserved for prolonged, persistent or worsening hydronephrosis and/or recurrent symptoms |
| van der Toorn et al15 | Laparoscopic transperitoneal (57) vs open (57) | Mean 8.1 vs 7.8 | Mean 12 vs 72 min | Symptom resolution, no conversion/reintervention, decreased hydronephrosis (US) and/or improved drainage (RS) | 98 Vs 95 | US + RS in first 50 pts, then renogram omitted if US showed decreased hydronephrosis |
| Garcia-Aparicio et al16 | Laparoscopic transperitoneal (26) vs open (32) | Mean 0.4 | – | Improved hydronephrosis (US) | 100 | US at 1 mo, 6 mos, 12 mos; MAG3 at 6 mos |
| Lee et al17 | Robotic transperitoneal (33) vs open (33) | Mean 7.8 vs 7.6 | Mean 10 vs 21 | Symptom resolution, significant + persistent improvement of hydronephrosis (US) and/or t1/2 less than 10 mins (RS) | 94 Vs 100 | – |
| Sorensen et al18 | Robotic transperitoneal (33) vs open (33) | Mean 9.2 vs 8.2 | Mean 17 vs 19 | Symptom resolution, improved hydronephrosis with renal growth (US) and/or improved drainage (RS) | 97 | – |
| Barbosa et al19 | Robotic transperitoneal (58) vs open (154) | Median 7.2 vs 1.2 | Median 33 vs 31 | Hydronephrosis improved (US) by at least 2 grades (0–5 scale) | 74 Vs 70 | US at 0–6 mos, 6–12 mos, after 12 mos; MAG3 if no improvement on US |
| Riachy et al20 | Robotic transperitoneal (46) vs laparoscopic transperitoneal (18) | Mean 8.8 vs 8.1 | Median 22 vs 43 | Absence of symptoms, hydronephrosis improved by at least 1 grade (US), stable US with symptom resolution or t1/2 less than 10 mins (RS) | 100 Vs 88 | – |